Red Spots on Legs: Causes and Treatment Options

Erythema of the lower extremities?

Hello Dr.
Chen, I stayed in Moscow for three months from April to June last year.
However, on the night I returned to Taiwan, I noticed widespread red spots on my legs.
The spots were not swollen or itchy, and I had no sensation when they appeared.
After about three to four days, the spots naturally faded and disappeared.
During the period from June to October, the spots appeared about three to four times.
After November, the erythema started to appear more frequently.
When it is mild, the spots are sparse, but during significant weather changes, like in the past couple of days, the erythema covers my calves to thighs.
Based on previous experiences, the erythema usually disappears after about a week, and I do not feel anything during these episodes; I only notice them afterward.
I have consulted dermatologists at Wan Fang Hospital and Taipei Chang Gung Memorial Hospital, but the doctors were not very certain in their responses.
They only mentioned that it does not significantly affect my health and prescribed a general eczema cream.
I also consulted a traditional Chinese medicine doctor at Taipei Chang Gung, who prescribed circulation-enhancing medication for a few weeks, but there was no significant improvement.
I would like to ask for your advice, Dr.
Chen.
Should I seek consultation at another hospital? Thank you!

Mr. Hsu, 30~39 year old female. Ask Date: 2006/03/03

Dr. Huang Ruiyun reply Dermatology

If there is still no lump and no symptoms, it is advised to leave it alone.

Reply Date: 2006/03/03

More Info

Understanding red spots on the legs can be a perplexing issue, especially when they appear sporadically and without accompanying symptoms such as itching or pain. Based on your description, it seems that you have experienced episodes of red spots on your legs that appear and disappear without any discomfort. This pattern can be indicative of several underlying conditions, and while it may not pose an immediate health risk, it is essential to understand the potential causes and treatment options.

Firstly, the transient nature of the red spots you describe suggests that they could be related to a benign condition known as "erythema." Erythema refers to redness of the skin caused by increased blood flow to the capillaries. This can occur due to various factors, including environmental changes, allergic reactions, or even stress. Given that you mentioned the spots tend to appear during significant weather changes, it is possible that your skin is reacting to temperature fluctuations or humidity levels.

Another possibility is that these spots could be a manifestation of a condition known as "petechiae," which are small, pinpoint red or purple spots that can occur when tiny blood vessels break under the skin. However, petechiae typically do not fade away quickly and may require further investigation if they persist or increase in number.

Since you have already consulted dermatologists at two different hospitals without receiving a definitive diagnosis, it may be beneficial to seek a second opinion from a specialist who focuses on vascular or autoimmune conditions. Sometimes, conditions like vasculitis or other inflammatory disorders can present with similar symptoms, and a thorough evaluation may be necessary to rule out these possibilities.

In terms of treatment, since the red spots do not seem to cause any discomfort or health issues, the focus should be on monitoring the condition. If the spots become more frequent or change in appearance, it would be wise to document these changes and present them to your healthcare provider. Keeping a diary of when the spots appear, their duration, and any potential triggers (such as dietary changes, stress levels, or environmental factors) can provide valuable information for your doctor.

Additionally, while topical treatments like hydrocortisone cream may help with inflammation, they may not be necessary if the spots are not causing any symptoms. However, if you notice any itching or discomfort, over-the-counter antihistamines may provide relief.

In conclusion, while the red spots on your legs appear to be benign and self-limiting, it is essential to remain vigilant and consult with a healthcare provider if you notice any changes. Seeking a second opinion from a specialist may provide further insights into your condition. Remember that skin conditions can be complex, and sometimes it takes time to arrive at a clear diagnosis. Keeping an open line of communication with your healthcare providers and being proactive about your health will serve you well in managing this issue.

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