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Q: Brown freckle-like splotches on my feet/ankles ( Answered,   2 Comments )
Question  
Subject: Brown freckle-like splotches on my feet/ankles
Category: Health > Conditions and Diseases
Asked by: tswanson-ga
List Price: $25.00
Posted: 29 Jul 2005 23:19 PDT
Expires: 28 Aug 2005 23:19 PDT
Question ID: 549710
For the past 6-9 months I've had these brown freckle-like splotches
develop on the top of my feet at the base of my toes, around the sides
of my feet and ankles and slowly working up my ankle and lower calf. 
I can't help but think it is a circulation problem since it seems like
it's just under the surface of the skin.  There is no noticable change
in texture of the skin in those areas and no pain whatsoever, but I do
notice slightly lowered sensation where the splotches are present.

When I first started noticing it about 6 months ago, I thought it
would go away, but it's stayed the same and I believe has spread
further up my leg (now to the middle of my calf on my left leg). 
About 3 months ago my girlfriend decided to do some accupressure with
bell jars on my ankle, and the one that was able to stick caused a
small dime shaped ring of light brown discoloration that has remained
to this day.

I'm worried about what the condition might be and the type of medical
attention it may require.  I've considered seeing a dermatologist, but
it's quite tough to fit into my current schedule.  I'd appreciate any
help in figuring out what this is and whether it is serious or just a
minor issue.

Request for Question Clarification by crabcakes-ga on 30 Jul 2005 11:43 PDT
Hi Tswanson,

    Do your splothes look anything like these?
http://www.cdc.gov/ncidod/dvbid/dengue/slideset/spanish/set1/images/petechiae2-small.jpg

Are you taking any medications? Supplements? 

What is your age?

I'd like to answer your question, but I'd like some further clarification.

Regards, Crabcakes

Clarification of Question by tswanson-ga on 30 Jul 2005 18:52 PDT
I'm 25, no medications or supplements...  in good health...  but that
picture you provided doesn't really look like what I have.  I got a
few pictures posted up and here they are:
<a href='http://tcswanson.com/pictures/foot1.jpg>http://tcswanson.com/pictures/foot1.jpg</a>
<a href='http://tcswanson.com/pictures/foot2.jpg>http://tcswanson.com/pictures/foot2.jpg</a>
<a href='http://tcswanson.com/pictures/foot3.jpg>http://tcswanson.com/pictures/foot3.jpg</a>
Answer  
Subject: Re: Brown freckle-like splotches on my feet/ankles
Answered By: crabcakes-ga on 30 Jul 2005 23:03 PDT
 
Hi Tswanson ,

  Before I begin, let me remind you that this answer is for
informational purposes only. It is not intended to diagnose, treat, or
to replace sound medical advice from a licensed physician.

   What you describe sounds like petechiae. The pictures you supplied
most certainly appear to be petechiae. Petechiae are intradermal
hemorrhages, that is bleeding under the skin. They are small spots,
and can look differently on different people. In fact, the picture in
the clarification was of a foot with petechiae. Petechiae change in
color as they fade? red to purplish, tan and yellow. A simple but
non-definitive test to determine if this is petechiae is to press on
the skin with a thumb or finger. Petechiae do not blanch when pressed,
while other skin disorders will blanch (becomes pale upon pressure)

  Causes of petechiae are many, and can be from a simple allergy to
medication (that?s why I asked if you were on any medications) to a
low platelet count to an infection to leukemia, among others. If for
nothing more than peace of mind, please visit your doctor for an exam
and diagnosis.

Petechiae on a child?s back
http://www.dental.mu.edu/oralpath/lesions/petechia/petechia2.jpeg

On a hand
http://medic.med.uth.tmc.edu/edprog/Path/infdis/infect59.jpg

On a leg
http://sfghed.ucsf.edu/ClinicImages/Petechia%202.1.JPG
http://www.annals.org/cgi/content/full/123/11/894

?There are many conditions in which petechiae may be seen. These
conditions range from very minor to very major. The common causes of
petechiae include local injury and trauma, allergic reactions,
autoimmune diseases, viral infections that impair blood coagulation
(clotting), thrombocythemia (an abnormally high platelet level),
certain medical treatments such as radiation and chemotherapy,
idiopathic thrombocytopenic purpura (ITP), leukemia and other bone
marrow malignancies that may lower the number of platelets, and sepsis
(bloodstream infection). Petechiae are normally seen right after birth
in the newborn and after violent vomiting or coughing. Drugs such as
the anticoagulants warfarin (Coumadin) or heparin, aspirin, and
cortisone can also cause petechiae.?
http://www.medterms.com/script/main/art.asp?articlekey=4853


?Purpura are larger areas of bleeding into the skin that begin as red
areas that become purple and later brownish-yellow. Purpura usually
appears in crops and may disappear over three to five days. It can
occur on any part of body but is more common on specific areas, such
as the front of the shins.?

?They are caused by a small local amount of bleeding within the skin.
Deeper bleeding beneath the skin may be seen as bruises (ecchymoses).
The difference between petechiae and abnormally prominent blood
vessels can be shown by applying pressure to a red spot. If it is
caused by an abnormal blood vessel the redness disappears temporarily.
By contrast when pressure is applied to purpura the spots do not pale.

Petechiae result from tiny areas of superficial bleeding into the
skin. They appear as round, pinpoint-sized dots that are not raised.
The color varies from red to blue or purple as they age and gradually
disappear. Petechiae commonly appear on the lower legs, but may be
distributed all over the body. Petechiae that appear during illness,
especially illness with fever, can be a different story. Because the
presence of bacteria in the bloodstream (classically Meningococcus,
the causative agent of "spinal meningitis") can be heralded by the
appearance of petechiae, these little marks are searched for during
the skin examination of a sick child. If present, they could be be the
heralds of very dangerous sepsis, even in a child who does not look
all that ill.?

?Treatment is directed at the underlying cause of the petechiae. For
example, someone with petechiae caused by an infection is given
antibiotics. If petechiae are caused by allergy to a medication, the
medication may need to be stopped. A person with petechiae due to a
low platelet count may need a transfusion of platelets or other blood
factors. A person with leukemia or cancer may need surgery,
chemotherapy, or radiation therapy. Petechiae caused by injury need no
treatment. Applying an ice pack off and on for 24 hours after the
injury may reduce further petechiae. The petechiae will fade in time.?
http://skin-care.health-cares.net/petechiae-purpura.php

Your doctor will likely ask the following questions:
	Is this the first time the person noticed petechiae?
	When did they develop?
	Has the person been ill lately?
	Has there been a recent injury or accident?
	Are there any other symptoms?
	What medications is the person taking, if any?
	Does the person have any medical conditions?
	What is the person's typical diet?

?What are the long-term effects of the disease?
The long-term effects of petechiae depend on the cause. For example,
petechiae caused by injury will usually fade in time, and cause no
long-term effects. When the cause is allergy to a medication, stopping
the medication should end the condition. A person who has a severe
infection with petechiae may be very ill, and death can occur.

What are the risks to others?
Most cases of petechiae are not contagious and pose no risk to others.
If the cause of petechiae is an infection, such as mononucleosis or
meningitis, the infection may be contagious.

What are the treatments for the disease?
Treatment is directed at the underlying cause of the petechiae. For
example, someone with petechiae caused by an infection is given
antibiotics. If petechiae are caused by allergy to a medication, the
medication may need to be stopped. A person with petechiae due to a
low platelet count may need a transfusion of platelets or other blood
factors. A person with leukemia or cancer may need surgery,
chemotherapy, or radiation therapy. Petechiae caused by injury need no
treatment. Applying an ice pack off and on for 24 hours after the
injury may reduce further petechiae. The petechiae will fade in time.?
http://atoz.iqhealth.com/HealthAnswers/encyclopedia/HTMLfiles/972.html

?Petechiae are commonly due to a low platelet count
(thrombocytopenia). Platelets play an important role in blood
clotting. Causes of a low platelet count include:
	Autoimmune disorders, such as lupus or rheumatoid arthritis
	Viral infections, such as mononucleosis and measles (rubella)
	Certain medications
	Bone marrow disorders, such as leukemia
Treatment depends on the underlying cause. If you develop a petechial
rash, see your doctor promptly.?
http://www.ohiohealth.com/healthreference/reference/DA46DE3B-87BB-41DF-9C32CF6767B70904.htm?category=questions

?A petechia (puh-TEE-kee-uh, plural petechiae puh-TEE-kee-eye) is a
small red or purple spot on the body, caused by a minor hemorrhage
(broken capillary blood vessels). Forceful coughing or vomiting can
cause facial petechiae, especially around the eyes. Newborns often
have facial petechiae from the tight squeeze through the cervix. Thus
petechiae are fairly common and in general of no concern.
Petechiae are a sign of thrombocytopenia (low platelet counts), other
disorders of coagulation. If they appear during illness, especially
illness with fever, they may be a sign of septicemia (blood-borne
bacterial infection), especially of Meningococcus (a causative agent
of meningitis)?
http://en.wikipedia.org/wiki/Petechiae


?What to expect at your health care provider's office:Your doctor will
perform a physical examination and ask questions about the bleeding,
such as:
	Has there been a recent injury or accident?
	Have you been ill lately?
	Have you had radiation therapy or chemotherapy?
	What other medical treatments have you had?
	Do you take aspirin more than once a week?
	Do you take Coumadin, heparin, or other "blood thinners" (anticoagulants)?
	Has it occurred repeatedly?
	Has a tendency to bleed into the skin been present lifelong?
	Did it start in infancy (for example, with circumcision)?
	Did it start with surgery or a tooth extraction?
The following diagnostic tests may be performed: 
	Coagulation tests including INR and prothrombin time
	CBC with platelet count and blood differential
	Bone marrow biopsy?
http://www.shands.org/health/information/article/003235.htm

More on petechiae
====================
http://www.healthopedia.com/petechiae/

http://forums.obgyn.net/pcos/PCOS.0208/0538.html

http://my.webmd.com/hw/health_guide_atoz/stp1380.asp


More pictures
==============
On an arm
http://www-instruct.nmu.edu/cls/lriipi/micro/petechiae.jpg

On a man?s back
http://www.dentistry.leeds.ac.uk/oralpath/viruses/viral%20infections/340%20images/other%20viral%20images/infectious%20mononucleosis.jpg

http://www.derm.ubc.ca/morphology/graphics/morph049.jpg

Thighs
http://www.dermnetnz.info/vascular/img/vasc3-s.jpg

Leg
http://www.macmed.ttuhsc.edu/Morgan/bleedingdisorders/images/Untitled-29.jpg

Hand
http://www.macmed.ttuhsc.edu/Morgan/bleedingdisorders/images/Untitled-11.jpg

I hope this is the information you were seeking. Please visit your
doctor soon to rule out anything serious. Please also request an
Answer Clarification, if any part of my answer is unclear, and i will
be happy to respond to this question.

Sincerely, Crabcakes

Search Terms
============
petechaie
Comments  
Subject: Re: Brown freckle-like splotches on my feet/ankles
From: jbirdee-ga on 24 Aug 2005 22:29 PDT
 
http://www.skinsite.com/info_schambergs_disease.htm

I found this while searching for petechiae which I have on my ankles, lower legs
Subject: Re: Brown freckle-like splotches on my feet/ankles
From: lw2-ga on 18 Sep 2005 20:29 PDT
 
crabcakes,

Do you have pics (or direct me to) that show what petechiae looks like
on someone with leukemia? Same goes for each of the other potential
causes.

I've had this (or what looks similar to tswanson's pics) for over 5
years now, I mean, I just thought it was frekles, since I have
frekles.

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