Pigmentation

Q: I am a 62 year old, fair complexioned English lady who has lived in India since birth. About 10 years ago I developed small spots of light copper colour pigmentation on each forearm; about 2 to 3 inches up from my wrists, in line with my thumbs. Since then, the pigmentation has spread all the way up my arms to where the arm meets the shoulder; and is still spreading. Besides this, a (birthmark red) pigmentation, started about 5 years ago, in the area where my chest and neck meet. Now this pigmentation has spread; in a mottled line, ONLY UP EACH SIDE of my neck to the curve where the jaw meets the cheek. I have been to a Dermatoligist and he says that I have a DISORDER and not a DISEASE; and he has no name for it and says he can not do anything for me. When I was 8 years old I had an accident. Boiling water fell on my chest and arms; when I ran in to someone carrying a bowl of boiling water. I had Third Degree burns, and was hospitalised for about 4/5 months. At that time the burn areas were pinkish/white, and mottled my arms. With time, the skin became uniform coloured and looked normal, except for the scar tissue and ridges of proud flesh on my chest which are whiteish. I have lived an active, normal life, and done a lot of outdoor activities and athletics. Im wondering if my problem is due to exposure to the sun, on my already damaged skin. Why has it taken so long to affect me? Now my arms are mottled, and a different colour to the rest of my body. It is unsightly, so I wear long sleeves to cover my arms. I cannot cover the area along the sides of my neck to my jaw. I feel miserable, with out hope of help, for a cure. I hope you can help reply. Thank you.

A:The answers to most of your questions depend on the diagnosis of yourdisorder, which appears has not been arrived at. Birth marks do not begin at the age of 55 years. Pigmentation could be representing photomelanosis/toxic melanosis/cutaneousamyloidosis/actinic keratosis etc. However careful examination will reveal additional findings which will help in arriving at a diagnosis. Sometimes a skin biopsy may be required. I suggest you seek another dermatologists opinion.

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