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Last Reply:

non-itchy, bruise like, red lesions on arms and legs

Lis54321 posted:

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. Blood clotting, etc. all 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

5 Replies |Watch This Discussion | Report This| Share this:non-itchy, bruise like, red lesions on arms and legs9 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. <ul><li>Red marks on arms appearing and reappearing for last 7 months, legs appeared more recently twice in last week.</li><li>Smooth on skin like a bruise, not raised on skin or not bumpy</li><li>painful when first coming</li><li>Not itchy</li><li>No fever or any other symptoms proceeded the onset of this</li><li>For the last 2 months has had stomach pain and gas but, it may be a seperate issue or may be related?</li><li>appear quickly and are gone within days. Reoccuring every few days.</li></ul>He has had blood tests done and all the bloodwork comes back normal. Blood clotting, etc. all 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: <a rel="nofollow" href="http://share.shutterfly.com/action/welcome?sid=0CaN3LNm1Ys3pQ&emid=shareprintviewer&linkid=link5&cid=EM_sharview">http://share.shutterfly.com/action/welcome?sid=0CaN3LNm1Ys3pQ</a>

Capsaicin responded:

Do any lesions appear on his back or posterior thighs?

Report This| Share this:non-itchy, bruise like, red lesions on arms and legsDo any lesions appear on his back or posterior thighs?

Capsaicin responded:

Do any lesions ever appear on his back?

Report This| Share this:non-itchy, bruise like, red lesions on arms and legsDo any lesions ever appear on his back?

Elizabeth_WebMD_Staff responded:

Dear Lis54321,

I can't imagine how scary and frustrating for your family.

While waiting for response from members and possible experts you may also want to post this with our Parenting Community.

Hope you find answers soon,
Elizabeth

Report This| Share this:non-itchy, bruise like, red lesions on arms and legsDear Lis54321, I can't imagine how scary and frustrating for your family. While waiting for response from members and possible experts you may also want to post this with our <a href="http://exchanges.webmd.com/parenting-exchange">Parenting Community.</a> Hope you find answers soon, Elizabeth

Lis54321 replied to Capsaicin's response:

No, once we thought one appeared on his back but, now we have more information and it may not have been the same thing. As difficult as it is to accept, it appears they are being done by himself. The dermatologist gave him an antihistimine and they thought that would help with an allergy which may have caused some pain sensation on his skin which then made him pinch or suck on his arms to relieve that pain. We were so sure he wasn't doing it to himself but, now we are pretty sure he was, maybe unconcously but, most of the marks are places his mouth could reach. A few would be very difficult to do like ones on the back of his arms but, not impossible since he is flexable. He is very friendly, has lots of friends, and does really good in school. We have a nice family and no stressers or new events that have happened recently. He has always been honest with us in the past so when he denies sucking on his arms before the marks appear we completely believed him. Now, with this new revelation from the dermatologist I have to second guess what he tells us because if he is doing it consciously then we have a whole different issue we are dealing with. Thanks for your questions and reply.

Report This| Share this:non-itchy, bruise like, red lesions on arms and legsNo, once we thought one appeared on his back but, now we have more information and it may not have been the same thing. As difficult as it is to accept, it appears they are being done by himself. The dermatologist gave him an antihistimine and they thought that would help with an allergy which may have caused some pain sensation on his skin which then made him pinch or suck on his arms to relieve that pain. We were so sure he wasn't doing it to himself but, now we are pretty sure he was, maybe unconcously but, most of the marks are places his mouth could reach. A few would be very difficult to do like ones on the back of his arms but, not impossible since he is flexable. He is very friendly, has lots of friends, and does really good in school. We have a nice family and no stressers or new events that have happened recently. He has always been honest with us in the past so when he denies sucking on his arms before the marks appear we completely believed him. Now, with this new revelation from the dermatologist I have to second guess what he tells us because if he is doing it consciously then we have a whole different issue we are dealing with. Thanks for your questions and reply.

Lis54321 replied to Elizabeth_WebMD_Staff's response:

Thanks for the suggestion. As I responed to Capsaicin, I think we have the answer now for the marks and the question that we will discover in time is why was he doing it. Was it allergy and pain so he was sucking on his arms to sooth them. The allergy medicine seems to be working and no more new marks since he started it a few days ago. Or was it some other reason and the medicine was more of a placebo effect or 'out' for him to not do it anymore. Frusturating for me as a concerned mom to think he wasn't telling me the truth. But, I think it interesting for other parents to see this case and if anyone can learn from it because if you had asked me a week ago I would have absoloutely positively said not possible he is not telling the truth about doing it to himself. Only after constant supervision and reinforcing that this 'new' allergy medicine and special lotion will work for his red marks did they stop. The special lotion is just regular lotion but, we told him it is 'special' and he shouldn't get it in his mouth. I put it on him 3 times a day and reinforce not to get it in his mouth and that it will help with his spots. He has it good at home, has friends and does good in school. He gets lots of attention. He was always very honest in the past. I never would have thought he was responsible. The dermatologists say there are very few things in nature that make linear marks patterned in the way they appeared on him. But, at least now I look at the situation with a new eye. Thanks again.

Report This| Share this:non-itchy, bruise like, red lesions on arms and legsThanks for the suggestion. As I responed to Capsaicin, I think we have the answer now for the marks and the question that we will discover in time is why was he doing it. Was it allergy and pain so he was sucking on his arms to sooth them. The allergy medicine seems to be working and no more new marks since he started it a few days ago. Or was it some other reason and the medicine was more of a placebo effect or 'out' for him to not do it anymore. Frusturating for me as a concerned mom to think he wasn't telling me the truth. But, I think it interesting for other parents to see this case and if anyone can learn from it because if you had asked me a week ago I would have absoloutely positively said not possible he is not telling the truth about doing it to himself. Only after constant supervision and reinforcing that this 'new' allergy medicine and special lotion will work for his red marks did they stop. The special lotion is just regular lotion but, we told him it is 'special' and he shouldn't get it in his mouth. I put it on him 3 times a day and reinforce not to get it in his mouth and that it will help with his spots. He has it good at home, has friends and does good in school. He gets lots of attention. He was always very honest in the past. I never would have thought he was responsible. The dermatologists say there are very few things in nature that make linear marks patterned in the way they appeared on him. But, at least now I look at the situation with a new eye. Thanks again.

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