Red Spots on Skin: When to See a Specialist

Blood test

I have small, dense red dots on the inner side of my lower leg that are not painful or itchy.
After researching online, they resemble petechiae (similar to the images in this link: https://www.dcard.tw/f/girl/p/235207040).
This is the only area affected, and it measures approximately 3cm x 1cm.
I noticed it about two weeks ago and can confirm that I haven't scratched or bumped this area.
Six months ago, I had a health check that included tests for coagulation function and platelet count, and all reports were normal.
Last month, I had blood tests for other reasons, and both the platelet count and other parameters were normal, but coagulation function was not tested.

1.
Is the coagulation function report from six months ago still relevant? Is it possible for issues to develop within six months?
2.
Should I consult a hematologist or a dermatologist for this issue? Thank you.

Ya, 30~39 year old female. Ask Date: 2021/10/08

Dr. Hu Ziren reply Oncology

1.
Laboratory reports from the past three months are more valuable for reference.
2.
It is advisable to first consult a dermatologist to rule out localized dermatitis.
If there are no abnormalities and the red spots expand or are accompanied by bleeding in other areas (such as persistent gum bleeding), then a consultation with a hematologist should be pursued.

Reply Date: 2021/10/08

More Info

When it comes to understanding red spots on the skin, particularly in the context of your description of small, concentrated red dots on the inner side of your lower leg, there are several important factors to consider. Based on your account, these spots are not painful or itchy, which can help narrow down potential causes.
1. Understanding the Significance of Previous Blood Tests: You mentioned that you had a comprehensive blood test six months ago, which included coagulation function and platelet counts, all of which were normal. While these results are certainly valuable, it is important to note that medical conditions can develop over time. It is possible for coagulation disorders or platelet abnormalities to arise after a normal test result, especially if there are new symptoms or changes in your health. Therefore, while your previous tests provide a baseline, they should not be the sole reference point for your current condition.

2. Potential Causes of Red Spots: The appearance of small red spots can be attributed to various conditions. Some common causes include:
- Petechiae: These are small, pinpoint red or purple spots that can occur due to minor bleeding under the skin. They can result from various factors, including physical trauma, certain medications, or underlying medical conditions.

- Allergic Reactions: Sometimes, skin reactions can manifest as red spots due to allergies or irritants, even if there is no itching or pain.

- Vascular Issues: Conditions affecting blood vessels, such as vasculitis, can also lead to similar presentations.

- Infections: Certain infections, including viral ones, can cause red spots on the skin.

3. When to See a Specialist: Given that your symptoms have persisted for over two weeks without improvement, it would be prudent to consult a healthcare professional. In this case, both a dermatologist and a hematologist could provide valuable insights:
- Dermatologist: A dermatologist specializes in skin conditions and can assess the red spots directly. They may perform a physical examination and possibly a skin biopsy if necessary to determine the cause.

- Hematologist: If there is a concern regarding bleeding disorders or if the red spots are indicative of a systemic issue, a hematologist would be the appropriate specialist to evaluate your coagulation status further.

4. Next Steps: When you visit a specialist, be prepared to discuss your medical history, any medications you are currently taking, and any other symptoms you may have noticed. It may also be helpful to bring along your previous blood test results for reference.

In summary, while your previous blood tests provide a useful baseline, they do not rule out the possibility of new issues arising. Given the persistence of your symptoms, it is advisable to seek a professional evaluation. A dermatologist can help determine if the red spots are related to a skin condition, while a hematologist can investigate any underlying blood-related issues. Early intervention can lead to better outcomes, so do not hesitate to seek medical advice.

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