Red spots on skin: Pictures, causes, treatment

Red spots on your skin are typical and varies with age and setting, they can be many things. Below are example cases; some are trivial and others needed a personal visit to the dermatologist.

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1. Pityriasis versicolor (Tinea versicolor)

Online dermatologist question
15 year old girl. I have red spots/ blotches on my back, I just realized it as I stepped out of the shower. Do not know where they came from or if they’re of harm? Please help.

Online dermatologist  Answer
Based on the information and images of your back, this is possibly Pityriasis Versicolor, fungal infection resulting in white, reddish scaling patches on skin. This is more common in young people, combined with sun exposure. It is not dangerous or contagious. You can treat this with over-the-counter (OTC) Fundan (ketoconazole) schampoo over the entire body 2 times/week for 3 weeks or an anti-fungal cream twice a day for 10 days. If not better or it got worse after 6 weeks, see a dermatologist in person.

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2. Telangiectasia

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23 year old man. I have a raised red spot on my nose it has been there for a while, just wondering if it is bad and if something can be done.

Answer
Based on the information and images submitted of your nose, this looks like a Telangiectasia: Small dilated blood vessels in surface of skin causing red spots. In exceptional cases it might be caused by an underlying disease, but in this case it looks normal, if you get more or it grows see a doctor in person. If it disturbs you from a practical or aesthetic point of view a dermatologist can easily help you to get rid of it either by laser or electrocoagulation.

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3. Shingles (Herpes zoster)

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40 year old male. Red spots appeared on my shoulder a few days ago and are itchy. I don’t have any known allergies.

Answer
This looks very much like like shingles, also known as herpes zoster, which is the reactivation of the chicken pox virus. It is a viral disease characterized by a painful skin rash with blisters in a localized area. See your GP for antiviral treatment such as aciclovir. This can become painful so consider paracetamol if uncomfortable.

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4. Insect bites

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29 year old female. I had feeling of itchiness started last Tuesday night. Last Wednesday, I had some fever and muscle pain. Thursday I started to see red spots around my chests and along side the body. Now I see a few spots on my arms, legs and over my face and scalp. It’s itchy and painful when touch.

Answer
This looks like Insect Bites, but the fact that you also have had a fever and muscle or joint pain makes it difficult to exclude other diagnoses such as Erythema Multiforme or Sweet’s Syndrome. These syndromes can be caused by different medicines or viral infections for example. I would recommend that you see a dermatologist as soon as possible for testing. You can take paracetamol to relieve the pain and the fever. The itchiness can be relieved with a topical steroid cream.

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5. Contact dermatitis caused by plants

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30 year old male. The red spots appeared a few days after working In my yard. They are on my left lower leg, arm and fingers. It appears they have gotten worse and are blistering. First appeared 4-5 days ago on Thursday or Friday. I have treated them with hydrocortisone 1% and Zanfel. Also, have taken Benadryl.

Answer
Based on the information and images of your leg and history, this looks like Contact Dermatitis caused by plants: Most often caused by primula or chrysanthemum. Itching rash, red streaks with blisters is common. Treatmnent: Avoid the causing plant. Use cortisone cream as you are doing twice a day for a week. If it doesn`t improve see a physician.

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6. Leukocytoclastic vasculitis

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My husband who is 48 years old. just noticed tiny red dots (not bumps) on the lower shin/calf areas of both legs, approx 6″ beneath knees and 1″ above ankle. He is at tailend of a cold or sinus infection. Lots of coughing and head and chest congestion with clear mucous. This was his first time to take Musonex DM.

Answer
Thanks for the images of the legs and the history. It looks like it could be Leukocytoclastic Vasculitis, an inflammation of small blood vessels in the skin. The typical red spots that appear on the feet, ankles and lower legs may sometimes spread up to the thighs and even to the trunk. This type of reaction is usually caused by a previous infection or new medication. Elevation of the legs and the use of compression stockings may be useful. Treatment of the underlying infection or removal of the drug causing this may of course help the lesions to clear quicker. If no improvement is noted within 1-2 weeks, if the lesions should spread or if abdominal pains are present, I recommend that you see a dermatologist in person for blood work and possibly a skin biopsy, if needed, a treatment plan.

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7. Angioma (Cherry)

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First noticed it a couple of months ago after nicking it with razor and it bleed a lot. It has increased in size since then and is painful. I have had squamous cell cancer in the past and am wondering if this could also be a cancerous growth.

Answer

Thank you for sending your case. Based on the information and images of your stomach, this is possibly an Angioma. An angioma is a small and benign proliferation of small blood vessels. Very common in adults. Several such lesions can appear with different sizes. Normally red in color but they can also be dark red, blue or violaceous. Harmless. Treatment is not needed unless for cosmetic reasons. If it becomes darker or you have pain or discomfort, I recommend that you see a dermatologist.

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Sources:

Pityriasis versicolor. Renati S, Cukras A, Bigby M BMJ. 2015 Apr 7;350:h1394

Epidemiology and determinants of facial telangiectasia: a cross-sectional study. Mekić S et al. J Eur Acad Dermatol Venereol. 2019 Oct 8. doi: 10.1111/jdv.15996.  

The risk of herpes zoster virus infection in patients with depression: A longitudinal follow-up study using a national sample cohort.
Choi HG et al Medicine (Baltimore). 2019 Oct;98(40):e17430.

Arthropod Bites and Stings Treated in Emergency Departments: Recent Trends and Correlates.
Vaughn MG et al. Wilderness Environ Med. 2019 Aug 10.

Poison Ivy, Oak, and Sumac Dermatitis: What Is Known and What Is New? Kim Y et al. Dermatitis. 2019 May/Jun;30(3):183-190. 

Leukocytoclastic vasculitis with Koebner phenomenon associated with Ehlers Danlos syndrome. Haddock EES JAAD Case Rep. 2019 Jul 31;5(8):666-668.

Cherry Angiomas-Further Expanding the Phenotype With Somatic GNAQ and GNA11 Mutations. Siegel DH JAMA Dermatol. 2019 Feb 1;155(2):148-149.