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Developed painless lesions on lower leg. Should I be concerned?

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Dr. Shailja Puri

Pathologist and Microbiologist

Practicing since :2006

Answered : 7311 Questions

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Posted on Sat, 12 Jan 2013 in Skin Hair and Nails
Question: Hello,

Yesterday I discovered 3 painless, non pus filled skin lesions on my body. One is on my right lower leg (right below the back of my knee), the other on my left lower leg, below my right knee, and the third is below my right buttock.

The two on my legs are a few shades darker than my skin color and flat. One is smaller than the size of a pencil eraser and other is about size of pencil eraser. They are dry and uniform in color. The one on my buttock is blackish purplish and looks like a dry splotch.

I am a 28 year old Hispanic female, no history of melanoma in family that I know of. I have lived in tropical climates for several years (3+). I am usually cautious with my skin, wear face sunscreen daily, and sunscreen all over my body when at beach or in sun for prolonged periods of time.

I normally don't check my skin as I should, so it's possible these lesions have been around for a while and I never noticed, or that they are from bruises I didn't notice or some other accident. I am not sure how concerned I should be!

I currently live in a small border town of Thailand, where the nearest dermatologist is a 9 hour bus ride away. I would appreciate any help you can give. I can also send pictures of the lesions. Thanks!
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Answered by Dr. Shailja Puri 3 hours later
Hello XXXXXXX,

Thanks for your query.

The three lesions that you have mentioned are macules (flat lesions) and have a variegated appearance (pigmentation is not uniform). Some spots are more pigmented and some are less pigmented. The margins of all three lesions are irregular. All three are on lower limb and are painless. Features like itching are also absent so possibility of fungal infection is ruled out.

On the basis of history and examination, these lesions seem to be a skin related problem.

The minimum which needs to be done is proper examination of the lesions and skin biopsy from all three of them.

There are a variety of skin lesions which present in this manner like naevi which may be benign or dysplastic and more aggressive lesions like malignant melanoma.
Absence of constitutional features like decreased appetite, weight loss, weakness etc. rules out malignant melanoma clinically. However, biopsy examination will confirm the diagnosis.

Visit to the dermatologist is necessary as soon as possible.

In case you have more queries, I will be glad to answer.
Dr Shailja P Wahal

Above answer was peer-reviewed by : Dr. Mohammed Kappan
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Follow up: Dr. Shailja Puri 7 hours later
Hi,

Thank you for your response.

Can you please let me know what questions I should be asking the doctor? Or what I should ask the doctor to check for?

Thanks,

XXXXXXX
doctor
Answered by Dr. Shailja Puri 14 minutes later
Hello XXXXXXX

Thanks for your query.

You need to consult a dermatologist and discuss your problem in detail. You may discuss about the nature of lesions - benign or malignant; whether it needs treatment or can it be left alone; etc.

The three lesions that you have mentioned should be shown to the doctor. Clinical examination will guide further investigation. A biopsy of the lesion is entailed. The examining doctor will be the right person to order other required investigations.

I hope it helps. Should you have other concerns, I will be glad to help you.

Dr Shailja P Wahal
Above answer was peer-reviewed by : Dr. Prasad
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