Conditions
Disseminated Superficial Actinic Porokeratosis
Disseminated superficial actinic porokeratosis (DSAP) is a rare inherited skin condition that causes dry, itchy lesions on the arms and legs. However, some people can develop DSAP as a result of immunity problems. It usually affects fair skinned people over the age of 35, and it is more common in women than in men. About half of the children of those with DSAP will have the condition, but accumulated sun exposure is needed to bring this tendency out.
The lesions usually begin as a small brownish-red spot which can expand to a diameter of 10mm. No sweating occurs in these lesions, but exposure to the sun can cause these to itch. DSAP usually affects the lower arms and legs, but in rare cases it can also affect the forehead and cheeks.
The best way to stop the lesions from growing is to avoid exposure to the sun. This is especially important as whilst development of skin cancer in people with DSAP is uncommon, many patients with the condition have already experienced a significant exposure to the sun so it is important to have yearly check-ups on the lesions.
Unfortunately treatment of DSAP does not usually improve the condition dramatically. Creams can offer some slight help with cryotherapy also often being prescribed. Cyrotherapy is when the lesions are removed by freezing them using liquid nitrogen, but this can sometimes lead to areas of hypo-pigmentation. Other treatments include ointments and oral medicines.. However, some people can develop DSAP as a result of immunity problems. It usually affects fair skinned people over the age of 35, and it is more common in women than in men. About half of the children of those with DSAP will have the condition, but accumulated sun exposure is needed to bring this tendency out.
The lesions usually begin as a small brownish-red spot which can expand to a diameter of 10mm. No sweating occurs in these lesions, but exposure to the sun can cause these to itch. DSAP usually affects the lower arms and legs, but in rare cases it can also affect the forehead and cheeks.
The best way to stop the lesions from growing is to avoid exposure to the sun. This is especially important as whilst development of skin cancer in people with DSAP is uncommon, many patients with the condition have already experienced a significant exposure to the sun so it is important to have yearly check-ups on the lesions.
Unfortunately treatment of DSAP does not usually improve the condition dramatically. Creams can offer some slight help with cryotherapy also often being prescribed. Cyrotherapy is when the lesions are removed by freezing them using liquid nitrogen, but this can sometimes lead to areas of hypo-pigmentation. Other treatments include ointments and oral medicines.
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i have problems in walking since 08 with very weak legs and now i have a very bad rash on my lower leg looks like the same as what in the picture . been in pain since 1998 with my spine there are lots of things happening i think i my have MS or MND it would be nice for a good doctor to get back to me thank
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I have also tried many different topicals and also the Levulon light with really no result. My derm did perform an IPL treatment on my face and it seemed to get the few that were on my face. Do you know if IPL or other laser treatments would work for the arms or legs?
Asked on 24 Jan 2012 22:59 by Makell
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Itching can be a sign of a lower immune system for multiple reasons. Exaccerbations of DSAP with severe itching have been reported in case reports with MS, HIV, cancers including colon and others. I had an exacerbation and severe itch for months after many years of only the spots without any symptoms other than their appearance. I went on vacation and in a rare episode on vacation was out in the sun. This is what flared mine. Ironically, I had a skin biopsy a couple of years later and was diagnosed with mycobacterium chelonae, an infection that more often occurs in the immune suppressed, and can also occur in instances of exposure such as that from pedicures (the water is the source). The skin with DSAP is less of a barrier to common insults, so I think the DSAP pre-disposed me to this weird infection also. Protecting the skin, which is supposed to protect us,is key, not only in terms of sun, but also in terms of injury and infection. And you are all correct, there is not a lot of research, and no researchers that I have found that are actively pursuing this. FYI: I am a physician, though not a dermatologist; I went crazy doing research in the height of me 5 months of uncontrollable itching.
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I have just read these. I was diagnosed with DSAP 10 years ago. It has recently made rapid progression on my arms and legs despite the fact I have not been exposed to the sun for years. There is NO help from the medical profession: NO treatment: NO research being done and basically no GP or dermatologist here in the UK seems to know much about it and in my experience it's a case of "here, try this lotion"!! It's a horrible skin condition to have and no one cares. WE NEED HELP!
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do the lesions always itch with this condition? I have dry lesions on my lower legs that are getting more with age, and have not faded in 2 years, but they don't itch. My GP has no idea what they are - could it be this?
Asked on 6 Aug 2011 00:35 by Jackie
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The lesions can itch when overly dry or hot but it's not usual. If your GP doesn't know what they are then get a referral to a dermatoligist and don't wait until they get worse. good luck
Posted on 16 Dec 2011 20:51 by Bonnie
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This is a good answer
I have had DSAP since my late 20s it has now spread to my face and neck, although originally started on my legs. Took ages to get a diagnosis, tried some treatments, but this proved ineffective. Little or no help exists for sufferers, my scars as so bad I try to keep my legs and arms covered most of the time, however I like to be out in the sunshine so its a no win situation
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On the program it does not mention how to stop the itching of DSAP. Have suffered constant intense itching without relief since lesions first appeared on legs only following heart bypass vein removal. diagnosed by dr but only prescribed e45 cream which is no help.
Asked on 26 Mar 2011 21:00 by Debbie
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I've had DSAP for a few years now, mainly on my arms but also to some extent on my lower legs. My arms can itch quite intensely, particularly after sun exposure. My friend gave me some Doublebase cream to try, and this is the best treatment that I have found up to now. I lather it on morning and night, and during the day if necessary, and it certainly does calm the itching. Not sure if it is available on prescription only??
Posted on 17 Jun 2011 19:42 by Ange
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This is a good answer