13 January 2022 2 4K Report

Upon reviewing a clinical case one of my student fellow documented during practice, me and my supervisor were not sure about the diagnosis and what to do next. A healthy 27 year-old man of Vietnamese origin presented with a complaint about reddish spots which had increased in number in a few days. The spots were flat and tiny, having different size ranging from a fraction of a millimeter, to a maximum of about a millimeter. They were more numerous on the arm and forearm, but the top side has much more than the bottom side. There were a few on the chest, but almost none on lower extremities. The spots appeared isolated, diffused on both arms. Other skin features include presentation of acne. His medical history was unremarkable, apart from a few episodes of anterior uveitis which resolved 4 years ago. He did not show any fatigue, fever, pain or gastrointestinal symptoms. Dermoscopy shown in attached figure.

Me and my supervisor believe the spots were of vascular origin. The bright red color, along with clarity showed that the vessels close to the surface were involved, some seem dilated. The fellow student made a diagnosis of angioma, but we believe the diagnosis could be much more benign, like thin dry skin in winter. However, due to numerous and diffused appearance, we just want to make sure to also rule out other serious possibilities. What's your take on this?

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