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Ask Dr. Nair Your Own Question
Dr. Nair
Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 9190
Experience:  MBBS, MD (Dermatology, Venereology & Leprology)
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Have small red dots on lower legs by ankles lots of red

Customer Question

Have small red dots on lower legs by ankles lots of red dots. Not a bump can not feel and raise in skin. Just lots of reds dots. Any idea what this could be and should I be worried
Submitted: 1 year ago.
Category: Dermatology
Expert:  Dr. Nair replied 1 year ago.


Thank you for your question. My name is***** and I will do my best to provide a useful input.

Would a photograph of the affected area be possible at your convenience?

Customer: replied 1 year ago.
I would be glad to
Expert:  Dr. Nair replied 1 year ago.

Thank you for the photographs. Tell me does the redness of the spots fade with pressure? (you can use the bottom of a glass to check)

When did these spots appear?

Do they itch or hurt?

Customer: replied 1 year ago.
They appeared 2 to 3 days ago.. no pain no inching
Customer: replied 1 year ago.
They do not fade with pressure
Customer: replied 1 year ago.
Just very nervous
Expert:  Dr. Nair replied 1 year ago.

Unfortunately I cannot do a live phone call as I am not based in the US. I am therefore opting out of the question to open it to all experts so that one can call you - in case you do not receive a call in the next 30-45 minutes let me know and I will give you my thoughts on the matter. Regards.

Customer: replied 1 year ago.
Can you not tell me your opinion?
Expert:  Dr. Nair replied 1 year ago.

Sure I can - only thought you wanted a phone call instead of an online answer.

If these spots were itchy they would have been most suggestive of bug bites (insect bite reactions), but the lack of itching rules that out. Another condition called allergic dermatitis can sometimes have a follicular pattern and present with distinct red spots, but again this is usually itchy. Vitamin C deficiency can produce red spots but usually accompanied but significant pain in the leg bones.

That leaves the possibility of Leukocytoclastic Vasculitis (LCV). This is an inflammation of the small blood vessels in the skin and occurs as a result of hypersensitivity to antigens ranging from infectious agents (e.g sore throat, staph infection, hepatitis viruses) to oral medicines (e.g antibiotics) to autoimmune conditions (e.g lupus, arthritis) to a rarer idiopathic variety (that is no detectable underlying cause).

Diagnosis requires a skin biopsy along with appropriate blood tests as dictated by history.

LCV is not dangerous and not an emergency but I would recommend seeing a dermatologist in the next few days if possible to confirm the diagnosis.

As of now you can start Tablet Advil 400 mg thrice a day after meals + Calamine lotion twice a day over the spots + Capsule Lumitene 30 mg twice a day (all of these are available over the counter); and these should be of some help. Also avoid exertion as much as possible. You might find that no more spots appear over the next week or so and in that case you can just wait and watch as well - the spots might spontaneously clear up in the next 2-3 weeks.

Please feel free to ask if you have any queries. I will be happy to continue further and do everything I can to provide you with the service you seek.