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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 am 42 and was recently diagnosed with DSAP. It runs in my family. I am fair skinned and have light eyes. I have noticed that the sun makes DSAP worse and chlorinated pool water makes it better. I also have a severe vitamin D deficiency in which I have to get a prescription for. Would be interested in knowing if anyone has tried bee venom therapy?





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How often do you apply the bleach? Every day? How often is this necessary? Also, I wondered what type exfoliator you use and how often. Also, have you found any type of makeup/concealer that can be used that doesn't make the spots more noticeable, that looks natural? Thanks for any help you may offer!!

Wow....I was diagnosed with it - somethings that help me (not entirely get rid of them) is I shave, then put gloves on and apply bleach on my legs....it stings only a little but it seems to lessen them...also, I put compound w on some of the spots to "peel" them off - that helps too - then I also exfoliate with a dry brush and also pumice stone. My legs are pretty soft and I am diligently trying to protect them from getting worse - I was beginning to think it was from the water, but now, after reading all of this, I guess we are doomed:(....I also use Peel creams from Rhonda Allison (I am an aesthetician and sell her products online)...I use her Peel Cream and Ultra Exfole after the bleach has dried and settled in....so far, it has helped....





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Hi, your regimen sounds promising. Could you tell me how much it has helped with the spots though. Also, do you use the Compound W in addition to the Rhonda Allison Peel Cream and Exfole? And if so, do you use them together at the same time, and in what order? I have suffered with these things for years now, and am self-conscious wearing dresses, shorts, etc. Anything that will help I'd like to try, and I appreciated any info you have on this. Thanks!

It has helped - bleach applied directly on the legs with a 2x2 (square wipe) seems to work the best - I just tried some chlorine (yes straight chlorine) and it seems to be working a little better than the bleach. I will try this for a couple days and see how this works....everyone's skin is different, so if your as crazy as me and want to try it, I would recommend only doing a small test spot to make sure you dont have any reactions....I am not a doctor, just trying to find a way to get this ugly skin disorder off of my legs!!!

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I am 58 and I noticed the spots around the age of 35. I thought because I used the tanning beds, tanned in the sun etc. these spots were appearing but I found out after 4 dermatologists “inspected” me because they never have seen anything like this before, finally one dermatologist diagnosed DSAP right away. I have so many spots on both my legs and arms but my arms are much redder and people stare at me all the time and ask me what is wrong with me. It is so embarrassing and I live in California so summer time it is too hot to wear long sleeves to “Hide” my ugly arms. At this point neither one of my daughters has this thank goodness. My mother is from France and she is the one whom I inherited it from. She is 90 years young and does have these spots but they are not as bright red as mine are. I wish there was something we could use for the roughness, color etc. I have tried to lightly sand my arms with a light file so that my skin is soft like the rest of my body but it’s probably not the best thing to do for my skin. I have tried medications, lotions, freezing them but it left permanent scars so bad that it is the worse spots on my arms. What can we do???????Who can help us?????????????





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OH MY GOOD! I just came across this website and have so needed it!! I cannot believe how much i relate to all of these comments. So hard and embarrassing not to be able to wear shorts, etc. Not even looking to get tan, I would wear sunscreen 100 to just be able to feel comfortable to go in the ocean! I get so sad and upset during the summertime. no one understands. all my friends say they don't notice, but i know they are only being kind. Your comment reached out more then others since I am French! my mom was born in France as was I BUT she nor my sister had this. My mother passed last year at 87. She kept saying it was my fault of all the tanning i did in my younger years. I am 51 now and acquired it at age 25. Its prevented me from really enjoying life and having relationships. I am constantly told there is no cure, though i have trade many many ways. PDT a lotion then under a light. it helped alittle , but not much and as we know , insurance does not cover it. They say it is "cosmetic" which is a bullshit. My legs are the worse, on my arms i use a foundation powder coverup from Maybelline called Tan, but they just recently stopped making it! Anyway, all we all need is a decent coverup that doesn't look so fake and stays on in the water.

I have had these horrible spots for several years (I'm 55) and nothing helps. Every doc says nothing we can do except freeze and too many spots and will make worse scars. I'm praying for some treatment to come along, until then, I just keep on going, avoiding sun and applying moisture cream and anti itch cream. Not only sun, but heat makes mine itch, even if I'm inside, like while taking shower...etc. Guess it could be worse, I thank God it's not cancer or something like that.





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I have also suffered for about 30 years find it most embarrassing & very upset in the summer when I like to where short sleeve tops I wish there was a cure but at least after reading the comments in the article do not feel along, sadly my daughter has the same problem & my sister it makes you wonder why us. I am 74 years old





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My Dermatologist has prescribed Adapalene cream. This condition seemed to come on quite suddenly. I am retirement age and fair skinned yet to wear sunscreens. Thank you all for your helpful comments.





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I am 55, B+ and was diagnosed by my dermatologist in Chesterfield, MO. He is great. We need a solution. St. Louis summers are like walking around in soup. Bare skin is essential to survival with lots of SPF and reapplication-however, it is embarrassing. Also, it hurts shaving my legs as the heat seems to increase the amount of irritation this time of year. Any suggestion?





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I'm also from Chesterfield MO and am probably seeing the same dermatologist that you are seeing. If its who I think it is, he does know about DSAP and most dermatologists don't have a clue. I'm seeing him tomorrow to discuss what we can do to at least make this condition a bit better. Freezing is what I'm wanting to do.

Has anyone found essential oils of any help at all? I was told bergamot oil helps psoriasis and eczema patients and would like to know what folks may have tried





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I believe I have this condition as well. My father has similar lesions but, not as bad as mine. At first I thought I had a bad case of chigger bites but they didn't clear up or took a very long time to clear up. I am 50 fair skin, blue eye. I notice that in the winter my skin dries up and the symptoms are not as bad. I've been to several dermatologists and have been prescribed a bunch of cream and antibiotics, still haven't been diagnosed with DSAP yet. Had a biopsy done and they described it as ruptured hair follicles. Mine only appears on the inside of my shins with a few on the outside of my calf. Prominently on my left leg. Going to try the Epsom salt path next





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Hi i live in brisbane australia, and have this embarassing skin condition for so many years my father his mother also had it...drs and skin specialists all say the same no permanent cures and freezing would still leave scars....hence im really over it and hard in our climate to stay out of sun etc....good luck everyone on this site hope they find a cure. Linda

I live in the HOuston area and would like to know if anyone with DSAP has been treated by a Dr. and some type of positive results. I would be interested in knowing the name of the Dr.





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It looks like no one else has asked this question, so please fill in the rest of your details below.





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