Discolored arms?

June 20, 2005 4:24 PM

My dad, who’s 65, has what looks like one giant reddish liverspot all up and down his arms.

He’s gone to more than one Kaiser doctor, and they’ve all said, “you’ve got sun damage- live with it.”

I have seen a lot of people with sun damaged skin and none look like this.

Also, his skin is really thin- if he scrapes it at all, it just peels off.

He is always running into things (and always has) so there is bruising under it. Could it be that the discoloration is just bruising that never dissipates?

He was on prednisone for a long time (months) but has been off of it for almost a year.

Does anyone have any idea what this is? Or how to make it look better? He wears longs sleeves all the time now, even though it’s hot where he is.

posted by small_ruminant to health & fitness (12 comments total)

Well I must say that it seems just slightly incredulous that you have rejected more than 1 Doctor's opinion and despite your apparent greater knowledge on the subject you still deign to open it up to an AskMe debate.

My advice would be to have the matter settled by a dermatologist.

Age, genetics, sun exposure, steroid medications, smoking history and doubtless the interaction of a number of other factors will be (have been) contributive. I would guess that those port-wine stains will be difficult if not impossible to lighten or remove, if they are sun damage lesions: perhaps try vitamin E cream.
posted by peacay at 5:08 PM on June 20, 2005

Hope this isn't beating up disproportionately on small_ruminant, because I've seen lots of other examples, but I gotta say that this use of AskMe is a little disturbing. "(I / friend / neighbor / family member) has this weird medical symptom that concerns me, what is it?"

Now, no doctor worth a hill of beans would try to diagnose someone solely by a textual description of symptoms, especially one written by a third party. There's probably an ethical prohibition on doing so, at least I hope there is. As for all the medical laymen here, if a doctor won't make a remote diagnosis, what on earth chance do we have? To say nothing of undermining a diagnosis made by a (presumably) qualified series of doctors.

What really do you hope to gain here? Some "oh those lousy doctors, they're all in it together" commiseration? an acknowledgement that the HMO system might provide incentives to be too cursory in examinations? A suggestion for cosmetic products to cover up the symptoms? It seems like any real, functional end would be much better accomplished by consulting a local physician, or a directory of physicians if you don't trust the one you've seen so far (and I'm not trying to scoff at distrust in doctors -- it's important to have a trusting relationship with your medical professional). But... AskMe is not a clinic! It's nowhere near competent to that end! I know healthcare sucks in this country, but... is this really what it's come to?
posted by rkent at 5:09 PM on June 20, 2005

What really do you hope to gain here?

my guess is that someone might say "whoa, you know what, that sounds like [totally obscure thing my friend/neighbor/family member had], it's called [blah], you might want to do some research on it and then talk to your doctor.

I like Kaiser, and while I've never had a problem with any of the doctors there, my experiences and those of the people I know seem to show that the Kaiser philosophy isn't huge on preventive care. If you think something's up, you often need to do the legwork. Hell, I went into Kaiser three times saying "look, I think I have a gall bladder problem, and it needs to be dealt with quickly" and it wasn't until I came in JAUNDICED that they listened to me. So you know, there's that to consider too.

sadly i don't know anything that may be of use to the poster.

posted by fishfucker at 5:37 PM on June 20, 2005

Sorry to continue ff's sidebar.. It is indeed sad that people need to look beyond their doctor(s) for quality answers -- but I do believe a majority of docs don't get input from the full gamut of patients with condition x,y,z.

Internet communities, especially high quality examples like amefi, are imho a fantastic place to gather more information. It might not be so, if *everyone* reported *everything* to their doc about the drug for x,y,z -- but since that is obviously not the case, there is great value in posts like this.

Significant portions of treatment result information comes from far too small a sample base -- much like reviews of cars, electronics, games, etc. Many people simply don't go to their doc about things, but rather simply quit taking a pill or deal with the side effects.

My impression, from substantial deja-google-dig-fu'ing, is that far too much information is missed by, or simply not delivered to the people who can do the most with it.
posted by SpookyFish at 9:41 PM on June 20, 2005

I like Kaiser.... Hell, I went into Kaiser three times saying "look, I think I have a gall bladder problem, and it needs to be dealt with quickly" and it wasn't until I came in JAUNDICED that they listened to me.

How come you still like Kaiser? I was with them as a patient some years ago, and I could tell you stories. Kaiser is hell.
posted by semmi at 9:44 PM on June 20, 2005

Your dad should consult a dermatologist; the GPs at Kaiser are not skin specialists, and they're probably overworked.

(And if I had to go to a doctor three times before they acknowledged something I knew was going on with my body, I would throw a shit fit, not "like" them. But to each his own.)
posted by Specklet at 9:35 AM on June 21, 2005

Peacay and rkent, I'm guessing you haven't been initiated into the Kaiser method of practicing medicine.

You have to tell them what you want and then insist on it.

Just yesterday a Kaiser doctor tried to insist I take antibiotics for my ganglion cyst. These are reoccuring and I seem to know more about them than the doctor, despite the fact that they're common. This is typical.

Another typically Kaiser situation I went through: Kaiser insisted that everyone with any foot problem go to a plantar faciitis class. The teacher of the class then had to write referrals up for anyone who shouldn't have been there- like the folks with broken bones, ski injuries etc.

fishfucker: that's exactly what I was hoping for.

God help Kaiser patients who can't do their own research.
posted by small_ruminant at 11:06 AM on June 21, 2005

Well, the simple tearing, his age and the steroids suggest he's got vulnerable skin. I hear what you're saying about the service, but large port-wine stains would likely be as they have told you. IANAD though. It's just that a skin lesion particularly, is a very difficult thing to have much of a handle on in the e-nvironment. My mother has them (not huge), my father had them. Many older people get skin anomalies and remember, there was nothing much known or publicized about skin protection when your dad was growing up.
So I would still think: dermatologist & Vit E cream - although I seem to recall my father using some sort of fish based gel -- these are at best ameliorating emolients of course.
posted by peacay at 11:36 AM on June 21, 2005

You folks who commented are all nuts, for various reasons.

Post a picture, we'll figure out what it is. I doubt it's a port-wine stain (nevus flammeus), since those are present since birth and not acquired. Maybe it's acanthosis nigricans, in which case metastatic cancer is a possibility. Picture is worth 10^3 words!

Now, no doctor worth a hill of beans would try to diagnose someone solely by a textual description of symptoms, especially one written by a third party.

You've never been to medical school, have you? That's all we do for the first couple years.

I enjoy reading about these weird cases that come up here on MeFi from time to time. Then again, I am a neurologist, and we are charged with making rare and difficult diagnoses promptly and accurately. It's fun.
posted by ikkyu2 at 10:10 PM on June 21, 2005

Thanks, ikkyu2. I'll repost this in a week when I've got a pic. I don't figure it's nevus flammeus for the reasons you gave, but beyond that I'm without a clue.
posted by small_ruminant at 11:11 AM on June 22, 2005

ikkyu2 writes "You folks who commented are all nuts"

Phew! And I thought it was the drugs.
I thought portwine stain was only descriptive...live and learn. I wish I knew when you were likely to be cruising the site ikkyu2 - anyway, telling them to see a Dermo isn't quite that 'out there'. But then again, I'm sure you'd prefer your present phantomesque persona. I also think it's fun but I hope I'm only limited rather than actually detrimental....first principles and all.
posted by peacay at 2:17 PM on June 23, 2005

i still "like" kaiser, because i had a WORSE experience with the doctors through blue cross. one didn't speak english (which doesn't speak to his medical skills, but certainly makes it difficult to communicate symptoms, etc). The second, who I called asking to refer me to a clinic so that I could get some painkillers/get checked out for the extreme pain I was having flat-out refused until I went in to see him two days later at which point he told me he didn't "believe" in Vicodin (which I told him had helped with the pain) and that I "needed to eat sick food". He very reluctantly wrote me a prescription to get a sonogram but basically only after telling me flat out I didn't know what the fuck I was talking about and that I was basically full of shit.

Kaiser, although they didn't treat me right away (they *DID* sign me up for a sonogram immediately, on the first appointment, but it was a month off, and things reached a head before that) at least didn't treat me like i was a drooling retard who couldn't be trusted.

and kaiser physicians mostly practice in hosptials, which I just think makes more fucking sense. If I see a doctor and I need to get blood drawn, I don't want to have to make ANOTHER appointment and drive somewhere else to make that happen.

so yeah, I like kaiser like I liked Kerry.
posted by fishfucker at 2:13 PM on June 30, 2005