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What causes reddish lesions on hands?

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Posted on Mon, 16 May 2016
Question: I have red spots on both of my hands and cannot identify the cause. they are deeper red with higher body temperature and can sometimes fade to be not very noticeable. I have been HIV for 30 yrs and take a protease inhibitor cocktail, but I'm completely healthy and have been undetectable for more than ten years. Saw a dermatologist who suggested it might be pre-cancerous, but I reject that diagnosis based on the variation at different times, and the fact that it appeared as a sudden change.
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Answered by Dr. Kakkar S. (25 minutes later)
Brief Answer:
Kindly upload an Image

Detailed Answer:
Hello. Thank you for writing to us.

I am Dr.Kakkar (Dermatologist and Venereologist). I have read your question and I have noted your concern.

I request you to kindly upload a few Images of the skin condition so that I am able to guide you better. You may upload images at "Reports Section" Or you may mail me at YYYY@YYYY with the subject line as Attention:Dr.Kakkar

Also let me know what is your most recent CD 4 count? How long since you notice these spots?

Regards
Above answer was peer-reviewed by : Dr. Naveen Kumar
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Follow up: Dr. Kakkar S. (5 hours later)
I have just uploaded photos. My recent T cell count was approximately 550, highest in years.
I have also had bilateral hip replacement and was subsequently diagnosed with spinal stenosis, four degenerated discs. As a result I was prescribed ZORVOLEX as an anti-inflammatory.
Shortly after the redness began, and in addition I had small eruptions like cuts/blisters that accompanied some of the red spots.
I researched ZORVOLEX and found that a small percentage of patients respond with drug eruptions?
How long would I have to cease medication to eliminate that connection? I am certain these are not surface abrasions or rash and am concerned that it is a symptom of something else.
I saw my Doctor in San Francisco last month..had a biopsy which indicated these were perhaps pre-cancerous which I do NOT believe to be the case. My experience has always been that dermatology is the least accurate diagnostic medicine of all...at best Doctors seem to venture a guess and often have no definitive answer. Do you have any idea what this might be? Thank you.
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Answered by Dr. Kakkar S. (9 hours later)
Brief Answer:
A photosensitvity reaction to either ART or Hiv associated PCT

Detailed Answer:
Hi.
Welcome back.

Yes, dermatology is not a perfect science because different clinical conditions can present with similar signs and symptoms and a dermatologist has to keep most likely possibilities that are in sync with the underlying condition.
Your skin lesions are in a photodistributed location and are bilateral.
Though cancers like kaposi sacoma and lymphoma are more common in Hiv patients and can present with red patches and infiltrated plaques, I rule out kaposi sacrcoma (KS) because the lesions in KS are mostly distributed to head, neck and mucosae.
I would keep a possibility of either photosensitvity to ART drugs Or an Hiv associated porphyria cutanea tarda (PCT) due to liver involvement with Hiv, rather than a grave diagnosis of cancer. Moreover cancers are more common in patients with very low CD 4 counts (<50 cells). Your count is quite Ok.
I suggest you to continue with the topical steroid and use a sunscreen on exposed skin during the day.

Kindly get back to me if you have further query.

Regards
Above answer was peer-reviewed by : Dr. Deepak
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Dr. Kakkar S.

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Practicing since :2002

Answered : 9547 Questions

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What causes reddish lesions on hands?

Brief Answer: Kindly upload an Image Detailed Answer: Hello. Thank you for writing to us. I am Dr.Kakkar (Dermatologist and Venereologist). I have read your question and I have noted your concern. I request you to kindly upload a few Images of the skin condition so that I am able to guide you better. You may upload images at "Reports Section" Or you may mail me at YYYY@YYYY with the subject line as Attention:Dr.Kakkar Also let me know what is your most recent CD 4 count? How long since you notice these spots? Regards