'A Patient Voice' Community

9 years old. We are very worried about our son. He has seen numerous doctors including 2 dermatologists and none are able to identify what is happening with him. Early 2011 he started having red marks on his arms. They last anywhere from 3 to 5 days depending on how red they were when they came, darker lasts longer and then they disappear. They are painful from 1 to 2 hours before they start to show on his skin until a few hours after appearning to 1 day later. After that there is no pain the remainder of the time they are there. The pain he describes is like being pinched (for the lighter red ones) and like burning for the darker red. Episodes started and were infrequent only happening once every month- Jan/Feb/April/May then in June episodes started every 2 to 4 days. For mid-June to mid-July he has had 9 new episodes. Sometimes reappearing just as the others have disappeared and other times before the last episdode is gone. He can tell me they are coming before they appear and we can watch them appear on his skin. There is NO ITCHING and these marks are NOT self inflicted like from scratching. Last week for the first time they have started appearing on both legs around his knees. Before this it was mostly on his upper arm although a bad episode would extend down to his wrists and go to his upper chest. They are different than bruises in that they disappear quicker and when the red mark is touched they are not any more painful and sometimes he says they feel less feeling than if we touch a different spot on his skin where there isn't a mark.

• Red marks on arms appearing and reappearing for last 7 months, legs appeared more recently twice in last week.
• Smooth on skin like a bruise, not raised on skin or not bumpy
• painful when first coming
• Not itchy
• No fever or any other symptoms proceeded the onset of this
• For the last 2 months has had stomach pain and gas but, it may be a seperate issue or may be related?
• appear quickly and are gone within days. Reoccuring every few days.

He has had blood tests done and all the bloodwork comes back normal. The biopsy taken on day 2 of an episode read: Diagnosis: Punch biopsy, R arm, Superficial and mid sparse inflammation with infrequent eosinophils and neutrophils, with extravasated erythrocytes and subtle postinflammatory pigmentary alteration. Microscopic description: There is a sparse superficial and mid perivascular infiltrate of lymphocytes, histiocytes, and infrequent eosinophils and neutrophils. Around many blood vessels are extravasted erythrocytes. There is slightly uneven melanin deposition low in the epidermis with a few melanophages high in the dermis. Note: This is a difficult constellation of subtle changes to reconcile into a precise diagnosis...

Has anyone had this type of non-itchy rash that reoccurs and comes with pain? The doctor said it is not hives.

Pictures: http://share.shutterfly.com/action/welcome?sid=0CaN3LNm1Ys3pQ