Flat Red Dots on Skin: Causes and Concerns

[Question] Painless, non-itchy, non-fading red spots?

Hello doctor, I have scattered flat red spots on my arms, but not on my legs.
The red spots are the size of a pin, approximately 0.03 inches, and they appear more red when pressed.
When I prick them with a needle, they don't seem to spread or bleed much, as if I didn't pierce deeply enough, and they don't fade when released.
The number of spots is not as clustered or large as those seen in online images, and they are not raised like cherry angiomas.
Last year, during a labor health check, my hemoglobin level was 6.8.
What could these symptoms indicate? I've attached a picture: https://i.imgur.com/9DJ8VgI.jpg.
Thank you, doctor, for taking the time to respond.

Niming, 30~39 year old female. Ask Date: 2018/11/14

Dr. Wu Yuxin reply Dermatology

The medical regulations state that "a physician must personally examine a patient before providing treatment or prescribing medication..." Therefore, online diagnosis is also not permitted.
If you are experiencing significant distress, it is advisable to seek medical attention promptly.

Reply Date: 2018/11/14

More Info

The appearance of flat red dots on the skin, particularly on the arms and not on the legs, can be concerning and may indicate several underlying conditions. Based on your description, these red dots are small, pin-sized, and do not seem to change color when pressed, which is an important detail in assessing the situation.

One possible cause for these flat red dots could be petechiae, which are tiny, flat red or purple spots that appear on the skin due to bleeding underneath the skin. Petechiae can be caused by a variety of factors, including physical trauma, certain medications, or underlying medical conditions that affect blood clotting or platelet function. Given that you mentioned a past blood test indicating low hemoglobin levels (6.8), it is crucial to consider whether there might be an underlying hematological issue, such as thrombocytopenia (low platelet count) or other blood disorders.

Another possibility is that these red dots could be a manifestation of a skin condition such as dermatitis or an allergic reaction. Allergic reactions can sometimes present as small red spots, especially if they are associated with itching or irritation. However, you did not mention any associated symptoms like itching or discomfort, which makes this less likely.

Additionally, conditions like vasculitis, which involves inflammation of the blood vessels, could also lead to similar symptoms. Vasculitis can present with a variety of skin manifestations, including red spots or rashes, and may be associated with systemic symptoms such as fever, malaise, or joint pain.

Given the complexity of skin conditions and the potential for serious underlying issues, it is essential to consult a healthcare professional for a thorough evaluation. A dermatologist or a hematologist would be well-suited to assess your symptoms, review your medical history, and possibly conduct further tests, such as a complete blood count (CBC) or a skin biopsy, to determine the exact cause of the red dots.

In the meantime, it is advisable to avoid any potential irritants or allergens that could exacerbate your skin condition. Keeping the skin moisturized and avoiding harsh soaps or chemicals may help alleviate any irritation. However, self-treatment without a proper diagnosis is not recommended, as it could lead to further complications.

In conclusion, while the flat red dots on your skin could be attributed to various causes, including petechiae, dermatitis, or vasculitis, it is crucial to seek professional medical advice for an accurate diagnosis and appropriate treatment. Your past blood test results and the current symptoms should be discussed with a healthcare provider to ensure a comprehensive evaluation and management plan.

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