What are these tiny little dots...

April 6, 2009 7:48 AM

So, these red pinprick-size dots are appearing on my arms. They started a couple of weeks ago, and they aren't going away, and I'm pretty sure they are increasing in number, though not rapidly... is this anything urgent?

I'm on Wellbutrin SR. They are like tiny dots of blood under the skin, I think; they're not all over in the sense that you can see red blotches on my skin--they're small and you actually need to -look- to see most of them (though not all). I can't figure out if this is a side effect of the med or what. How likely is it that this is something serious? Do I need to see a doctor right away, or can I wait a week or two until my schedule frees up?

posted by Alligator to health & fitness (7 comments total)

It's hard to tell from the description but it sounds like these might be petechiae (small areas of bleeding from broken capillaries). Do they look like this?.

Petechiae are typically associated with low platelets (the cells in your blood that participate in blood clotting) - a condition called thrombocytopenia. The active ingredient in Wellbutrin (bupropion) has been found to have infrequent associations with thrombocytopenia. But to make a causal link is hard, also given that I/we don't know more of your medical history.

To be safe, if you're taking a drug and have petechiae, you should check with your doctor to 1.) establish whether or not this is a rash that could be from the drug, 2.) to determine if this is, in fact, a petechial rash, and 3.) if it is petechial, to get some blood work done.
posted by scblackman at 7:55 AM on April 6, 2009 [1 favorite]

You may also want to check for bedbugs. Check your sheets and mattress to see if you have tiny blood/dark spots. Is the rash worse in the morning, right after you get up? Does it seem to worsen overnight?
posted by catwoman429 at 8:15 AM on April 6, 2009

If it isn't a side effect of Wellbutrin, see a dermatologist. From my experience, ask them to screen your T-cells. I have similar-sounding spots, which turned out to be lymphomatoid papulosis; it's largely benign, but requires some aggressive treatment to avoid morphing into more dangerous conditions, and can't be treated topically.
posted by motsque at 8:23 AM on April 6, 2009

There are many possible reasons but I'll just throw this out as well: Are you doing any strenuous/long exercises with your arms? I got pinprick-sized dots on my arms that didn't itch or hurt after a week of too much knitting. I stopped knitting for a few days and they went away. I assume it was the knitting (could also possibly be an allergic reaction to the yarn, but with the timing and contact, seemed unlikely). If you are putting your arms under stress or tension for long periods of time, it could happen.
posted by bread-eater at 8:23 AM on April 6, 2009

Ask your pharmacist, in person, about Wellbutrin's side effects.
posted by Carol Anne at 8:45 AM on April 6, 2009

Hm, it does look like petechiae. I just made a doctor's appointment for Wednesday. Thanks!
posted by Alligator at 10:10 AM on April 6, 2009

You might be allergic, and you should stop taking it till you have talked with your doctor.

From the prescribing information:

Allergic Reactions: Anaphylactoid/anaphylactic reactions characterized by symptoms such as pruritus, urticaria, angioedema, and dyspnea requiring medical treatment have been reported in clinical trials with bupropion. In addition, there have been rare spontaneous postmarketing reports of erythema multiforme, Stevens-Johnson syndrome, and anaphylactic shock associated with bupropion. A patient should stop taking WELLBUTRIN XL and consult a doctor if experiencing allergic or anaphylactoid/anaphylactic reactions (e.g., skin rash, pruritus, hives, chest pain, edema, and shortness of breath) during treatment.

What you're describing could be erythema multiforme. Stevens-Johnson syndrome is a rare but serious drug reaction that you should be aware of too.
posted by selfmedicating at 5:09 PM on April 6, 2009