Shoulder Skin Changes: What Does a Dark Spot and Depression Mean?

The shoulder has a darkened area with a noticeable indentation when touched?

Hello, doctor.
I previously had a lump on my shoulder and went to the hospital for a consultation.
The doctor prescribed Augmentin for inflammation and mentioned that if the lump disappeared after finishing the medication, there wouldn't be much concern.
Indeed, after taking the medication, the lump disappeared, and I didn't pay much attention to it (although there is still a small dark spot the size of a pimple on my shoulder).
Until today, I noticed that the dark area on my shoulder (the color is not very deep) feels sunken when I touch it.
I would like to ask what this might indicate and if it is serious.

Xiao Zhu, 20~29 year old female. Ask Date: 2017/05/10

Dr. Wu Yuxin reply Dermatology

Without actually seeing the lesion, it is impossible to make a definitive diagnosis.
If it is causing significant distress, please seek medical attention as soon as possible.

Reply Date: 2017/05/10

More Info

When it comes to skin changes, particularly in the shoulder area, the appearance of dark spots accompanied by a depression can be concerning. Based on your description, it seems that you experienced a swelling in your shoulder that was treated with Augmentin, an antibiotic commonly used to treat infections. The fact that the swelling resolved after the course of antibiotics is a positive sign, indicating that the initial issue may have been related to an infection or inflammation.

However, the new development of a dark spot that feels depressed could indicate several possibilities. One potential cause is post-inflammatory hyperpigmentation, which can occur after an inflammatory process, such as the swelling you experienced. This condition is characterized by darkened areas of skin that can develop after the skin has healed from an injury, infection, or inflammation. The skin may produce excess melanin in response to the inflammation, leading to a darker appearance.

The depression you feel in the area could suggest that there has been some loss of tissue or changes in the skin's texture. This could be due to several factors, including:
1. Atrophy: This refers to the thinning of the skin, which can occur after inflammation or injury. The skin may lose some of its structural integrity, leading to a sunken appearance.

2. Scarring: If the initial swelling was significant, it might have led to scarring as the skin healed. Scars can sometimes appear darker than the surrounding skin and may also feel different in texture.

3. Dermatological Conditions: Certain skin conditions, such as eczema or psoriasis, can cause changes in pigmentation and texture. If the area has been itchy or irritated, it might be worth considering these possibilities.

4. Other Skin Disorders: Conditions like lentigines (age spots), seborrheic keratosis, or even more serious issues like melanoma can present as dark spots on the skin. The depression could also indicate a more serious underlying issue, such as a cyst or other skin lesion.

Given these possibilities, it is essential to consult a dermatologist for a thorough evaluation. They can perform a physical examination and may recommend a biopsy or other diagnostic tests if necessary. This will help determine the exact nature of the dark spot and depression and guide appropriate treatment.

In the meantime, here are some general recommendations:
- Avoid Irritation: Try to avoid any products or activities that may irritate the area further.

- Sun Protection: Use sunscreen on the affected area to prevent further pigmentation changes, as UV exposure can exacerbate dark spots.

- Moisturize: Keeping the skin hydrated can help improve its overall appearance and texture.

In summary, while the changes you are observing may not be immediately alarming, they warrant further investigation to rule out any serious conditions. A dermatologist will be able to provide you with the most accurate diagnosis and treatment options based on a comprehensive assessment of your skin.

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