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Conditions

Disseminated Superficial Actinic Porokeratosis

DSAP on legs

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 the condition as well. I noticed dry patches around the age of 37 and now it's much worse at almost 50. It is mostly on legs and arms and I feel embarrassed by it, like many of you. I feel like I've tried everything to treat this condition with mixed results. I will say that applying mineral makeup on the spots does make them less red and inflamed. I do this if I have a special occasion if my arms are showing. I use UltraPure Cosmetics because it doesn't have any irritating ingredients, etc. I also feel like applying coconut oil on my skin, improves it slightly. I recently saw a dermatologist who recommended a blue-light treatment, and he says the condition will improve greatly, so we'll see, however, the treatments are expensive and he recommended treating the areas twice.





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I have had this condition for the past 13 years. I am 46 years old and have the red spots on my arms, legs, hands, some on my chest and a few small ones on my face. I love working in my yard and swimming with my kids so it has been really hard to stay out of the sun. I hate covering up because I get so hot in the summertime. In the last year my spots have become so angry and itch so much that sometimes I can't sleep at night. It's such an intense itch and burning sensation that when it's bad I feel that I am going to go crazy. Nothing I have tried works to keep it under control. Does anyone have something that has worked for you? Any suggestions will be very much appreciated.





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I too have porakeratosis on my legs now starting on my arms. I decided to try A&D diaper rash cream and it has definitely calmed my angry spots. It looks much better after applying a few times a day for just a few days!! I can only hope it continues to lighten the spots 😃





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My mum was diagnosed with DSAP about 10 years ago after having it since she was about 40. I am 39 and have just started seeing signs of what I think might be the same condition. I have not yet seen GP but if it is diagnosed as DSAP, can you stop it getting worse at an early stage?





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I don't know that you can stop it. I have had it about 10 years - I started seeing "dry dpots" around 35-38 years old - don't exactly remember - and now I'm almost 48. My dsap has gotten some worse in the last year or two, but it still doesn't look like the picture at the top of the page. From what I have read and from what my dermatologist told me, sunscreen and covering up in the sun is the best prevention. I put sun screen on almost every day - I'm not the best example because I don't always do it! But I am a teacher and have to be out on the playground each day. from what I understand, if you start using sunscreen SPF 30 or 50 - it will help. I didn't do that the last several years - I just started wearing sun screen daily the last couple years. Perhaps I could have prevented my spots from showing now if I had been more careful during the last 10 years.

just diagnosed with DSAP worried about possibility of developing cancer. my lesions spread pretty quickly .does not itch but am wondering how long has this condition has been around? My dermatologist was looking it up in a text book and said it was rare





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From everything I have read, and from what my dermatologist told me, DSAP does not develop into cancer. Mine itches after I've been in the sun and if me skin is dry in general. It usually looks worse after I've been exercising or working outside. I have had DSAP for 10 years. I am 47 now, and only recently has anyone even noticed it. You can read about keratosis on the American Cancer society website. It's similar to dsap - also non cancerous.

I have had this condition for many years. I am now 71. I keep looking for a successful treatment. Right now I am using a 12% alpha hydroxy cream that is supposed to be successful with keratosis pilaris. I have no idea if it will work. Right now it seems to be aggravating the condition, but maybe it has to get worse before better?? I try to cover up in the sun, especially my face and arms. I do wear capris while golfing, but use heavy duty spf sunscreen on legs, arms, and use golf sleeves also. I've tried golfing in long pants, but the heat in Sacramento is miserable in the summer, so I do the capris. I think I am doomed to live with this condition and may as well toss the shorts.....





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Go to Amazon.com and buy some Sunspot Cream by Lane Labs. That will take care of it. It just exfoliates the skin little by little allowing healthy skin to grow back.

I have had DSAP since I was about 40. I'm now 64. My Doctor told me right away what it was. I also loved the sun but I haven't been in the sun since I found out what it was. My doctor said there is no cure yet. I just wear pants, and long sleeve shirts, and sunscreen. My spots don't get red because I always cover up and wear sunscreen. I'm going to try Natural Glow sun tanner and the Sally Hansen leg makeup. Thanks for the tip about the leg makeup. I am also grateful that DSAP is mostly harmless. I do hope they find a cure soon because it does alter your life and causes embarrassment! Unfortunately, it will take someone famous to have this disorder to bring awareness and funding for a cure.





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I have a few entries on this website. I sought out another Dermotologist. Two biopsies from my arm indicated some sort of eczema condition. I had a previous biopsy from my front side of my thigh that came back as DSAP. The second DERMA also thought that the rashes looked like an allergic reaction to something. His wife just happened to be an allergist. So I went thru a battery of patch tests and blood tests etc. They came back negative for food allergies. However, some tests came back positive for 6 chemical and dyes frequently found in clothing treatment for 'easy care' and 'wrinkle free'. A formaldehyde resin. Also positive for diasperse orange 3 dye. Two other substances regularly found in tooth paste, detergents, soap, topical lotions (propylene glycol). I have started TO AVOID THESE SUBSTANCES AND it is remarkable how many of my lesions are clearing up. Check out a site 'MYPATCHLINK'. there ARE MANY VIDEOS showing pictures of lesions etc and explanations for allergic conditions. Maybe you are allergic to something???





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I have this condition and also DO NOT wear shorts or skirts as it is worse there that on my arms. I wear hose in the winter but it is so hot in the summer. I have found that wearing Sally Hanson leg makeup helps hide the condition a bit. I do make sure my legs have a moisturizing lotion before I apply the makeup and I apply more moisturizer during the day too to keep the spots from drying out. The makeup is less than $10.00 so you may want to give it a try.





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I'm paranoid to wear short sleeves, shorts, and even a dress lately. I live in NC and it is extremely hot and humid during to summer. I have just recently ordered something called Solar-x, it is all naural. I read where one man has had some success with it along with taking Vitamin A and Flaxseed or Flaxseed oil. I'm going to give it a try, it can't hurt.





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have you had any success?

Rita, The directions state to use the Solar-x twice a day. I've had a lot going on lately and have not been as diligent as I need to be about putting it on twice a day. I do think the spots are not as red. I'm going to try and be more faithful about putting it on twice a day and see if there are any results. Someone else reported good luck with using Clearsal ultra pads every day. I may try this next if I do nit see any results from the Solar-x. How bad is your dsap? Debbie

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