Red-blue spots on the feet. Skin pigmentation on the legs: causes and methods of treatment
The appearance of spots on the legs is not an independent disease, but an alarming signal that the body sends in response to the development of a pathological process. Most often, redness in the form of dots or spots appears when skin diseases, and in some cases they can cause the patient unpleasant sensations of discomfort in the form of itching, burning and peeling. Such symptoms do not have an aesthetic appearance, as a result of which they can disrupt the psycho-emotional state of the patient. To eliminate these cosmetic and painful manifestations, it is necessary to find out why red spots appear on the legs.
Redness is always understandable
Red formations are a term that includes a wide variety of them:
- their presence can cause itching and flaking;
- be at the level of the skin or rise above them;
- they can have a bright rich red color or a light pale pink tint.
The spots can have different shapes, from small dots, or covering a large surface area of the skin.
Their appearance can be caused by the following pathologies:
- Consequence of allergen penetration. In this case, the spots may be small in size, sometimes in the form of small dots. Their appearance is accompanied strong feeling itching, peeling and the formation of small blisters filled with cloudy liquid. Allergies can occur to any household chemicals, cosmetics, shoes made from low-grade raw materials, and often to food.
- Avitaminosis. Consumption of small amounts of vitamins PP and C sometimes leads to the appearance of red-dark spots with a brown tint. A lack of vitamin B can cause spots with a pale red tint.
- Pathological process development of mycosis. This disease mainly affects the fingers of the lower extremities and the surface between them. The patient experiences severe itching and burning sensation.
- Varicose veins of the legs. This disease leads to a violation of the integrity of the walls of capillary vessels, which is why they burst, and dark-colored hemorrhages appear, sometimes in the shape of an asterisk.
- Diseases of the genital area. The appearance of small dots (symptom of the “necklace of Venus”) are localized on the legs in the groin area. They pass quickly, so patients often ignore them, but the disease does not disappear, but becomes chronic. This is typical for syphilitic lesions.
- Pityriasis rosea. A characteristic feature that distinguishes this pathology from other types of diseases is the appearance of spots that have a red rim. If you have an itchy pink spot on your leg, it could be ringworm.
- Vasculitis. The pathogenesis involves the destruction of vascular walls due to disruption of systemic blood flow.
Localization is important
Ankles
Despite the fact that the foot is hidden from outside attention, and the spots do not cause any particular cosmetic defect, their appearance is accompanied by a feeling of itching and burning. After scratching, a wet surface appears, which reacts with sweat, and an unpleasant odor appears.
In the photo there are pronounced red and pale spots on the legs and feet:
Red spots on the soles of the feet can be observed due to several pathological processes.
Dermatitis
An inflammatory disease that affects the surface layer of the skin, the epidermis. In the biomechanism of occurrence, the main role is played by:
- bacterial pathogens;
- exposure to ultraviolet radiation;
- disruption of metabolic processes;
- fungal and viral infection.
Allergy
It is distinguished by itching, the rash looks like dots and pustular blisters.
Main reasons:
- products;
- household chemicals and cosmetics;
- wild and cultivated plants (wormwood, poplar fluff).
Fungal infection
The main reason is non-compliance with the rules and regulations of personal hygiene:
- wearing someone else's shoes;
- visiting public places (swimming pool, sauna, solarium) without personal protective equipment or your own slippers.
The chance of getting a fungal infection of the skin is much higher in patients who have flat feet, which causes the feet to ooze a large number of sweat, creating a humid environment.
Hemangioma
At its core, it is a benign neoplasm consisting of vascular membranes. It has characteristic feature at the initial stage of the process, which allows an accurate diagnosis to be made. The patient develops a large number of red dots on the feet that have an irregular configuration and varied shapes.
Varicose veins
Hemorrhages appear dark brown color, shaped like stars or small spots.
Diabetes
One of the symptoms (diabetic foot) makes the foot dark burgundy, which indicates a clear metabolic disorder.
Dysbacteriosis of intestinal microflora
The disease is accompanied by a large area of redness irregular shape.
Autonomic disorders
Especially those that occur against the background of prolonged stress and depressive states, sometimes due to exposure to heavy physical exertion. The body uses an adaptation mechanism that reflexively expands the lumen of capillary vessels. This reaction is externally manifested by reddish spots on the sole and other parts of the body.
Rubella and chicken pox
Rubella and chickenpox virus appear as small red spots on the legs.
Toes
The pathogenesis of this symptom most often involves fungal infection genus candida. The provoking factor is increased humidity and excessive sweating between the toes. This happens as a result of wearing small shoes or violating the rules of personal hygiene (insufficient foot care).
In addition, there is a group of diseases that begin to manifest themselves with this symptom.
Allergic reactions
In this case, the rash initially appears in the area of the big toe and is shaped like red dots on the toes. With insufficient therapy or its absence, the redness increases in diameter and begins to itch severely.
Psoriatic lesions
As in the previous case, the disease can begin with localization on the thumb, but the spot has an elevated position compared to other areas of the skin.
Erysipelas
With this disease, the rashes have a clear boundary and are accompanied by pain, especially when pressed.
Understanding the causes in children
The appearance of this symptom in young patients indicates (in most cases) the appearance of an allergy. This is explained by the fact that food introduced into a child’s diet causes intestinal dysfunction.
But this is not the only reason why bright red or pale spots appear on a child’s fingers:
- Pityriasis rosea, scabies and dermatitis.
- Skin rashes and psoriasis.
- Childhood diseases (rubella, chickenpox and scarlet fever).
- Exanthema. It has viral etiology and occurs in children under 3 years of age.
Modern methods of treatment
The appearance of red spots on the skin of the legs should not be ignored. Any manifestations should be accompanied by a visit to the doctor. This is primarily due to the fact that it is very difficult for a patient without appropriate qualifications to differentiate (distinguish) the type of rash. And from correct diagnosis The choice of treatment method depends.
It is especially important to pay attention when this sign appears in the youngest patients. Timely treatment allows you to avoid the development of undesirable consequences.
There is no single method of treatment for the occurrence of rashes on the legs, since this symptom can be eliminated by acting on the underlying cause of the disease.
For each individual case, individual prescription of therapeutic agents is used.
Antihistamines
This group includes:
- Tavegil;
- Claritin;
The prescription of such drugs occurs if the rash is of an allergic nature.
Antifungal medications
Remedies that eliminate the effects of candida fungi are effective when redness occurs on the toes and toes as a result of the penetration and subsequent development of a fungal infection. In this case it is prescribed:
- Exoderil (available in cream form);
- Lamisil (release form - spray for external use);
- Triderm cream: relieves symptoms of fungal inflammation, has the ability to stop the development of bacterial microflora.
Angioprotectors
They tone the venous walls of blood vessels, which is why there is a positive effect on rashes localized on the legs, with the development varicose veins veins Doctors give preference to the following medications:
- Hesperidin;
- Venarus and Detralex;
- Venozol or Phlebodia.
Medicines including adrenal hormones
Allows you to reduce inflammation in psoriatic rashes. Recommended use:
- Prednisolone;
Cytostatic agents
Can be used in running forms psoriasis with lesions on the toes:
- Cyclophosphamide;
- Fluorouracil.
Antibiotics
These are drugs that have an inhibitory effect on bacterial pathogens. They are prescribed if the spots are caused by a bacterial infection, which happens with erysipelas or vasculitis. It is recommended to administer the following dosage forms in complex therapy:
- Ceftriaxone;
- Biseptol or Furazolidone;
- Amoxicillin or Amoxiclav.
Antiviral medications
Their use makes it possible to achieve positive dynamics in the treatment of pityriasis rosea. External ointments that are applied to the affected areas of the skin surface are well suited for this purpose. Recommended use:
- Zovirax;
- Acyclovir.
Non-steroidal dosage forms
Facilitate the course of diseases in which there is a symptom of spotty rashes with a red tint on the legs. Often prescribed:
- Naproxen;
- Aspirin or Diclofenac;
- Ibuprofen and Indomethacin.
Physiotherapy
In addition to the use of medications, a positive effect in therapy can be achieved by visiting a physiotherapy room for the following procedures:
- exposure to Darsonval currents;
- use of paraffin applications;
- electrophoresis using antihistamine drugs;
- therapy using magnetic radiation or ultraviolet radiation.
The effectiveness of hardware physiotherapy can enhance skin regeneration and relieve inflammation. The vessels regain their former elasticity, the lumen increases, and they cease to be brittle.
The appearance of even small spots on the foot or other places should prompt you to contact a medical institution for consultation with a doctor. Most skin pathologies can quickly progress and develop into chronic forms.
It is very important to make an appointment with a doctor, and not visit dubious healers and false healers. Their treatment can aggravate the course of the disease, since their treatment is aimed at eliminating the consequences, and not the main cause.
Red dots on the legs (spots, rashes) can be flat, convex or bumpy. They also come in different sizes, from small red dots to large spots. Their forms can be varied, and they can be itchy or not. They can form not only on the legs, but sometimes on the arms and torso.
Causes
Allergies and irritations
Allergies can cause red rashes on the legs and other parts of the body. An allergic reaction in some people may be associated with certain foods, certain medications, or changes in temperature environment, insect bites and much more.
Allergic rash
Allergens, for example, can also trigger the development of atopic dermatitis, which results in red raised spots or large spots that are usually itchy and more common in children than adults. But atopic dermatitis may not be related to these factors, but may arise for other reasons (its nature is not completely clear).
Atopic dermatitis may be associated with allergens, but may also occur for other reasons There is also another condition called contact dermatitis. This reaction in the body is caused by irritants such as latex, cosmetics and other substances when they come into contact with the skin. This condition is usually accompanied by itching and blistering on the feet or any other part of the body that is affected. The best solution for this case is to try to find out what substances cause this reaction and avoid them.
Eczema
Eczema Eczema is another possible non-contagious cause of dry, red patches that can sometimes be swollen and painful. Eczema occurs when the skin reacts to allergens or irritants such as nickel, poison ivy and many others. But it may also be related to internal factors– diseases of the digestive system, endocrine or nervous system, disorders of the immune system (including HIV).
Eczema can range from skin rashes to healthy skin and cones in different periods. This condition has some genetic links, so some people are predisposed to this disease.
Finally, it is more common in children and usually appears on the legs and other parts of the body such as the face and neck.
Prickly heat
Miliaria is an itchy rash of varying severity This is an inflammation of the hair follicles that is usually seen on the lower extremities. According to medguidance.com, folliculitis is usually caused by shaving your legs. In some cases, the spots can be very itchy. It can be avoided by avoiding the use of razors and wax to remove hair.
Medications
Red rashes on the legs, especially on the lower parts of the legs, can also be caused by taking certain medications. A good example is exposure to cytotoxic drugs used to treat arthritis. They may be associated with bleeding that occurs under the skin during therapy. This type of medicine also has some other side effects, including fever, sore throat, and blood in the urine or abnormal bruising.
Toxidermy is a negative reaction of a drug that manifests itself on the skin. It may occur several weeks after starting to take the drug orally. In most cases it is mild and does not require treatment. The photo shows a severe reaction in the form of leukocytoclastic vasculitis In addition to those listed above, some medications may have serious symptoms that require immediate medical attention.
Skin cancer
Some types of skin cancer, such as basal cell carcinoma and Bowen's disease, may be responsible. These conditions usually develop slowly and their symptoms appear as red marks that may even bleed in some cases.
Another type of skin cancer is invasive squamous cell carcinoma, it grows quickly and forms scaly tubercles. These manifestations should be taken very seriously as they can be life-threatening. In addition to other treatments, surgical removal may be an appropriate therapy for various types of skin cancer.
Vasculitis
This disease is caused by inflammation of the blood vessels in a certain part of the body. It can initiate thickening and weakening of blood vessels. If vasculitis is not properly controlled, it can cause damage to the tissues and organs surrounding the affected blood vessels.
Vasculitis Livestrong.com says that "in addition to red spots, symptoms of vasculitis include pain, loss of appetite, numbness and weakness in the affected area, such as the legs." Actions that threaten immune system, infections or allergic reactions can potentially cause this disease.
Hives
Urticaria, also known as hives, causes red rashes that can appear on any area of the body. They are mainly triggered by exposure to allergens. May be the result of the body's reaction to certain medications, insect bites, pollen, animal dander, or exposure to adverse conditions (heat or cold) and other factors.
Hives can be caused by food allergies, excessive heat, medications, etc. It is usually very itchy Usually, urticaria spots are accompanied by severe itching. The best idea is to avoid substances that you are allergic to and also cover your body from insects such as bees, wasps, etc. to be safe from stings. According to the American College of Allergy, Asthma and Immunology, “approximately 20 percent of people will experience hives in their lifetime.”
Infections
Usually our skin is very sensitive to certain infections. Fungal or bacterial infections can lead to various severe skin conditions that can cause red spots to form. Such damage, caused by bacteria or fungi, may take some time to heal.
Schamberg's disease
Schamberg's disease This condition occurs when blood vessels penetrate closer to the surface of the skin. It is characterized by reddish-brown spots that usually begin to develop on the legs and then spread to other parts of the body. They are usually not painful and come from blood vessels shining through the skin. They are reddish-brown in color due to the iron content in the blood.
Red-brown skin color on the lower legs can cause dermatofibroma. Usually with this disease there are formations hard buds, which may be tender, itchy, or painless in some cases. In fact, this non-cancerous growth can remain on the skin for quite a long time. But if bumps on the skin cause discomfort, you should seek medical help.
Other reasons
Apart from the above mentioned reasons, there are other potential causes of this problem such as ingrown hairs, reaction to sulfate medications or birth control pills, peripheral arterial disease, diabetes, erythema nodosum, scleroderma, insect bites and others.
Associated symptoms and signs
The appearance of red spots on the legs may exist along with some symptoms, but this depends on the type and nature of the spot. On the other hand, it is also worth recognizing that not all red rashes exhibit additional symptoms. But some of them can sometimes be itchy and very painful. All of them can manifest themselves as:
- Flat points
- Liquid filled
- Lumps or bumps
- Crusted
- The size can be very small or it can be very large
- Red dots may be numerous or very few depending on the nature of the triggering factors
- The edges of the points may be regular and well defined or undefined.
It is very important to note that the above symptoms will depend on the underlying causes. These signs may develop along with headache, nausea and vomiting, and even loss of appetite. Please note that severe symptoms require immediate medical attention.
Small red spots and dots
In fact, the development of small red spots (petechiae) on the legs can be due to a number of reasons, including those mentioned above.
According to John Caniff, Certified Nutrition Practitioner (CNP) from the Institute of Holistic Nutrition in Canada, “It's tricky when you can't explain a specific symptom, such as whether it's an allergic reaction or whether it's skin cancer, the spots on the skin are the result of internal bleeding or leaked capillaries. Bleeding will result in red, purple or brown spots, sometimes in clusters, and it will often look like a rash. Typically, these small red spots on the skin are non-itchy and flat and do not discolor when touched.”
Associated signs and symptoms
In many cases, small red spots on the legs are accompanied by some of these symptoms and signs:
- Unexplained nosebleeds
- Heavy bleeding during menstruation
- Dried blood under the skin
- Excessive gum bleeding
- Easy bruising or bleeding
- Hemorrhage in the joints.
Potential Causes
Bather's (swimmer's) itching on the legs is a disease that is caused when trematode larvae penetrate the skin while swimming in contaminated bodies of water. Humans are not a natural host for these types of helminths, so they die, and the rash goes away after a few days Small red spots and dots on the legs most often cause:
- Prickly heat
- Long-term stress
- Injuries and sunburn
- Sepsis
- Allergic reactions
- Malnutrition
- Acute pharyngitis
- Scarlet fever
- Infectious diseases
Red spots on legs without itching
Moles and birthmarks
These are colored markings on the skin that a person is born with and acquires throughout life. They can sometimes be red in color, especially vascular birthmarks, and they can be on any part of the body, including the legs. They are usually caused by abnormal blood vessels in the skin. Some types of birthmarks in young children may be large (such as port-wine stains) or raised (strawberry birthmarks). Some of them disappear in the first years of a child’s life, others can be removed in medical and cosmetology centers.
Follicular keratosis
This harmless skin condition can occur anywhere on the body. In fact, it is due to the overproduction of a protein called keratin. Keratosis results in the development of small red bumps that are most common on the thighs, buttocks and upper body, but can also develop on the lower extremities.
Acne (blackheads)
This skin condition can cause mild to severe symptoms. Typically, acne is characterized by the formation of bumps that sometimes develop into red or swollen patches.
Angiomas
Angiomas These tumors can develop on any part of the body. They are usually caused by blood vessels that stick together and appear as red, raised bumps without itching.
Other reasons
Other factors include boils, allergic reactions, heat rashes, intertrigo, rosacea, insect bites, measles, Lyme disease, dermatofibromas, petechiae, and diaper rash.
We must not forget that the same reasons can also cause itchy spots and vice versa.
Treatment
Red spots (rashes) on the legs or on the body in general can be caused by various factors. Therefore, each cause will be treated differently. That is why for effective treatment you need to know the diagnosis, which should be made by a dermatologist.
Local treatments and creams
Leg spots that are associated with keratosis pilaris can be managed with topical treatment. In addition, creams have the ability to reduce symptoms and get rid of red spots on the legs and other parts of the body. Common procedures include:
Hydrocortisone cream
In some cases, redness may be caused by irritation. This may be due to inflammation from sweat and friction. In such a case, hydrocortisone cream may help resolve the problem.
Antifungal ointment
This is one of the most important medicines for treatment if the cause is a fungal infection, which most often occurs on the feet. There are both topical and oral medications that can help speed up the healing of the red rash. Treatment results can be seen within a week or so.
Antihistamine therapy
If the problem is related to allergies, suitable medicine There will be antihistamines. If they don't work, you need to see a doctor for a diagnosis and other treatment.
Using moisturizers
Red rashes on the legs can be cured by using moisturizers. However, it is also very important to recognize that for some reasons this type of therapy may be less appropriate.
Gentle cleansing
A gentle cleanser may provide some help. However, you should avoid harsh soaps, which dry out the skin and aggravate the rough texture of the spots.
Warm compress
This is an effective technique that can help relieve pain and heal large, painful red bumps on your legs and thighs. It will also help relieve inflammation and burning. Warm compresses will promote blood circulation, leading to some relief.
To apply the procedure, you can pour warm water into a plastic bag and wrap it in a towel. Then place on the affected area of skin for about 10 minutes.
Varicose veins are a serious disease that causes not only aesthetic discomfort, but also causes pain over time and burdens a person’s life. The disease can manifest itself in the form of stars, nodes, but also spots of different colors: red, blue, brown. Why red spots appear on the legs, what complications can occur if the problem is ignored, and how to properly treat sore legs, read below.
At the initial stage of the disease, spots of blue or purple. They are small, barely noticeable, reminiscent of intertwined snakes. Then they expand, fill with blood, become scarlet, and increase in size. If a person ignores the problem, then over time the spot becomes solid, because the veins in the legs continue to expand and fill with blood even more.
If red spots appear, this does not always indicate varicose veins. Very often they are observed:
- In overweight people. In this case, under the influence of a large mass, the load on the legs increases, and subcutaneous hemorrhages appear - hematomas. In those people who do not suffer from varicose veins, these spots disappear relatively quickly, while in others they resolve slowly due to disruption of the normal blood supply due to varicose veins.
- With a lack of vitamin C in the body. Because of this, the vascular wall quickly becomes fragile, as a result of which red spots appear.
- When hypertension or heart failure is combined with varicose veins. The disease itself does not always lead to the appearance of red marks. But if a person has problems with the heart or blood pressure, then very often he can see scarlet clots on his legs.
Brown spots already indicate that the disease has begun to progress and turned into another disease - thrombophlebitis. This is a complication of varicose veins, manifested by the inflammatory process of the vein walls with the formation of a brown blood clot.
Thrombophlebitis can lead to rupture of a blood clot, carrying it through the bloodstream into the heart, eyes, and blood vessels of the brain. This can be fatal. That is why it is very important to begin treatment of varicose veins in a timely manner, even before the spots begin to turn red. And it is best to prevent their appearance and treat the spider veins in a timely manner.
spots of red and of blue color on the legs - these are signs of varicose veins themselves. And brown pigmentation is already a complication of the disease called thrombophlebitis.
What is the insidiousness of varicose veins spots?
The danger of pigmentation appearing on the legs is that at first a person does not take any measures, since the spots do not bother him, they do not hurt, do not itch, and only bring aesthetic discomfort. And then women feel the inconvenience because they cannot afford to wear skirts, they only have to wear trousers.
But men don’t see any problem with such stains at all: they put on their pants, hid their legs and went to work. Ignoring pathological pigmentation on the lower extremities leads to the fact that the patient is ultimately diagnosed with thrombophlebitis, thrombosis, bleeding from nodes, trophic ulcers. These complications can lead to limb failure and leg amputation.
Blue, purple, red spots with varicose veins should alert a person immediately. There is no need to try to hide the problem; sooner or later it will make itself known. Therefore, when pigmentation appears, you should immediately contact a specialist - a phlebologist, so that the disease does not begin to progress and lead to complications.
Spots are not always harbingers or complications of varicose veins. They can be a sign of allergies, dermatitis, eczema, mycosis, hemangioma and other diseases. A person should know what varicose veins spots can look like. A photo of red formations on the legs with varicose veins can be seen below:
Why do most women suffer from varicose veins?
Red spots on the lower legs due to varicose veins occur in almost 40% of the world's population. The weaker sex often suffers from unnatural skin pigmentation. This is due to the fact that the female hormone estrogen can reduce the tone of the vascular walls.
Also, the appearance of varicose veins and spots on the legs of the fair sex is influenced by the following factors:
- Pregnancy (as weight increases, the load on the legs increases);
- Childbirth (during the birth process the body tenses, blood vessels may burst, and later spots appear);
- Menopause.
During all these periods, a woman’s hormonal levels change, and the amount of sex hormones increases. And they weaken their tone vascular wall. As a result, the veins, under the influence of estrogen and progesterone, become sensitive, stretch, and lengthen.
How to get rid of varicose spots: conservative treatment
If the pigmentation has a red or blue tint, then surgical intervention can still be avoided, but provided that the spots are small.
Treatment of pigmentation on the legs will not bring results if the cause of the spots - varicose veins - is not eliminated. Only by getting rid of it can you remove colored formations. Therefore, therapy for pigmentation on the lower extremities should be carried out under the supervision of specialists - a vascular surgeon, phlebologist, dermatologist.
In the treatment of spots and varicose veins itself, you should adhere to the following recommendations:
When is surgery required?
If conservative methods Treatments for varicose veins do not help, or the doctor sees that the disease is in an advanced state, the spots on the legs have already acquired a brown tint, they have become large in size, then he prescribes surgery.
Types of surgical intervention to treat varicose veins and eliminate its symptom - spots on the legs:
- Phlebectomy is the removal of veins affected by varicose veins. The specialist removes the vessels through small excisions on the legs.
- Stripping is carried out if it is necessary to remove a large subcutaneous vein. An incision is made in the groin area, after the operation the surgeon ties the veins and applies a tight bandage to the legs.
- Sclerosis is the filling of blood vessels with an adhesive substance to prevent further rupture.
- Laser therapy is the soldering of veins using a laser beam reaching the affected organs through specially made holes.
If the operation is successfully performed without complications, the person is discharged from the hospital within a day, and after another week he can even go to work.
Preparing for surgery
Before undergoing surgery, the patient must:
- Pass necessary tests(blood, urine, ECG);
- Consult a phlebologist, surgeon, therapist;
- Maintain the condition of the veins at the same level, and prevent the situation with the legs from worsening. And for this you need to wear, use medicinal ointments, drugs that improve blood microcirculation and reduce the load on the limbs;
- On the day of the operation, take a shower and shave your legs;
- Come to the hospital in a good mood, put aside fears and prejudices.
Prevention measures
If a person is prone to the appearance of varicose veins, then he must always be on guard, and for this he must follow the following rules:
What to do if varicose veins are cured, but the spots remain?
Sometimes patients are left with spots after undergoing treatment for varicose veins. This can happen and there is no need to get upset or worry about it. The main thing is that varicose veins are cured, the rest is not so bad.
A dermatologist will help you cope with your aesthetic problem. He will prescribe laser correction. The manipulation lasts from 10 to 20 minutes depending on the size of the formation. The procedure is painless, harmless, and with the help of a laser you can completely get rid of spots in 3-5 sessions.
Attempts to remove spots on legs with varicose veins folk remedies will never bring results. Only a doctor can prescribe effective therapy diseases to quickly help a person get back on healthy feet.
If, based on the results of the examination, a surgeon or phlebologist has determined that the spots on the legs are a consequence of varicose veins, then they can only be gotten rid of if the person cures the disease itself. There is no other option for getting rid of stains on your legs. The sooner the patient seeks qualified help, the simpler, easier and faster he will be able to get rid of the disease and its symptoms - red, blue, brown pigmentation.
Spots on legs- This is a change in skin color in a clearly localized area of the legs. The shape and size of the spots vary greatly, and most often they do not protrude above the surface of the body.If roseola is not inflamed, it is almost impossible to detect, it is slightly paler than the surface of the body, does not peel off and does not merge with other spots. A similar form of spots is typical for patients with pityriasis versicolor, secondary syphilis, leprosy, and erythrasma.
Large vascular spots can be located on any part of the legs; they often merge with each other, their shape is irregular, and they are well defined. Such spots are called erythema. This spot is sure to be very itchy, the skin at the site of the lesion is inflamed and red. Erythema forms in patients with dermatitis, toxicerma, and eczema.
Hemorrhagic vascular spots can appear due to inflammation or without it, but they usually appear when hemorrhage occurs in the upper layers of the skin. If inflammation is present, vascular permeability increases. If there is no inflammation, vascular injury is the result of a bruise or contact with toxic substances.
Hemorrhagic spots can be of different sizes. Small spots with a diameter of up to one centimeter are called petechiae, slightly larger ones in the form of lines are linear purpuric spots, and large and round ones are called ecchymoses, while the largest ones are called hematomas. Syndromes in which hemorrhagic spots appear on the body are called purpura. Such conditions are typical for people suffering from hypovitaminosis, toxicoderma, vasculitis, as well as some infectious diseases.
If spots appear due to an increase in the lumen of blood vessels and when examining their vessels, the vessels are clearly visible, they are called telangiectasia. Such spots appear when the walls of blood vessels are paralyzed. The reason for their appearance can be either overheating or hypothermia of the skin, or physiological processes in the body ( typical for young people in puberty).
If the level of pigment in the dermis decreases or increases, dark or pale spots appear. If the pigmentation is increased, the spots will be beige to dark chocolate. Such spots are called chloasma, lentigo or freckles.
Freckles are small spots that appear on the body, including on the legs, when exposed to ultraviolet radiation. This is a hereditary trait.
Lentigo- these are spots that are on the body already at birth. The shape and size of these spots are varied; lentigo is often combined with increased keratinization of the skin.
Chloasma are called big dark spots, which most often affect the face, but can also form on the legs. Their appearance is associated with an increase in melanin production, characteristic of diseases of the thyroid gland, liver, and adrenal glands.
Areas of skin that are completely devoid of pigment are called leucoderma or vitiligo.
Small spots without pigment are called leucoderma. The true form of leukoderma appears in patients with typhoid or typhus, as well as secondary syphilis.
In addition, similar spots can appear with pink and pityriasis versicolor, psoriasis and eczema in those places where there were previously plaques.
Why do they appear?
The reasons for the appearance of spots on the legs can be either completely innocent or quite dangerous. For example, stains may result from hair removal, contact with synthetic fibers, or rubbing from shoes. If birthmarks do not bother you, do not change color or grow, you can forget about their existence.Often red spots appear after using detergent or cream. The allergy will immediately go away after the contact of the skin and the allergen stops. Red spots may indicate the development of a rather unpleasant disease called vasculitis. Therefore, you should pay special attention to them. The condition of the legs indicates the condition of the vessels and veins of the whole body. That is why, after consulting a dermatologist, you may well need to consult a phlebologist or vascular surgeon.
The appearance of dark brown spots may be a consequence of a lack of vitamins PP, C or A. If lighter areas of the skin appear, the body is probably lacking B vitamins.
Pink spots on the legs, covered with scales - this is most likely pink lichen. With this disease, only general treatment of the body is effective. Any treatment of the affected areas can worsen the disease. Therefore, if spots appear, you should consult a doctor.
Red spots
Reasons for appearance:- dermatitis,
- allergy,
- eczema,
The most common causes are dermatitis, allergies to household chemicals, pet hair or clothing fibers.
Also very common cause is mycosis. This is a fungal disease that is diagnosed in a laboratory. If a fungus is suspected, an analysis is prescribed, on the basis of which therapy will be prescribed. Antifungal medications act very quickly and if the diagnosis is made correctly, the result of treatment will be noticeable within a few days.
Some types of spots, for example those caused by the development of hemangioma, can only be removed surgically. Hemangioma can appear in an adult, or it can be congenital. This is not a malignant tumor and does not pose a threat to life and health.
One of the first signs of beginning varicose veins can also be red spots on the legs. They are usually combined with heaviness or pain in the lower extremities. If such symptoms are observed, you should visit a phlebologist. Varicose veins are dangerous because if done incorrectly and untreated, it can develop into thrombophlebitis, and the legs will become covered with trophic ulcers. If you identify varicose veins at the very beginning of the process, you can slow down the development of the disease in time. If there is a possibility of varicose veins, ultrasound examination is used for diagnosis.
White spots
White spots on the legs, as well as on any other part of the body, are scientifically called vitiligo, or simply dog. The more tanned the body, the more noticeable these spots are. This disease is a chronic one, and most often affects young women. Signs of the disease can appear at any age. It is painless, but causes inconvenience. In addition, these areas of the skin are completely defenseless against ultraviolet rays. The hair on the affected areas is also not colored. On the legs, spots most often affect the knees.The causes of vitiligo are unknown; doctors believe that the disease develops due to metabolic disorders.
Provoking factors may be:
- diseases of the gonads,
- adrenal gland diseases,
- thyroid diseases,
- severe emotional shocks.
From the point of view of traditional healers, the main cause of the development of vitiligo is disruption of the pancreas.
People with cold extremities, prone to dizziness and increased sweating are more susceptible to this disease.
The spot itches
Itchy skin is called puritis. The itching is sometimes so strong that a person cannot sleep at night and develops neurosis. Itchy spots of any color are a reason to immediately go to the doctor. Under no circumstances should you scratch these places, as the skin will definitely become inflamed, because micro-scratches can become infected.Itchy spots can appear with mycoses, dermatitis, varicose veins and many other diseases. If the appearance of itching and spots cannot be explained by any objective reasons, if they do not go away for a long time, or even grow, you should definitely undergo an examination.
However, sometimes the cause of itchy spots is very simple and not ominous - it could be excessive dry skin or allergies. You can cope with this problem yourself by eliminating the source of the allergy and moisturizing the skin with cosmetic lotions or milk.
You can try chamomile or string baths. However, sometimes such self-medication only leads to a deterioration in well-being.
Spots on arms and legs
Skin is a mirror of human health. Red rashes may be the result of hives. This disease is the appearance of red blisters on the body, similar to the blisters that appear after contact with nettles. Most often, hives appear on the chest. But it can also affect the entire body, including the legs and arms. This is a rather unpleasant disease that needs to be identified and treated as quickly as possible. If this is not done, the disease can lead to Quincke's edema. Quincke's edema is swelling of all mucous membranes respiratory tract, V severe case and without urgent help may result in suffocation.Spots on a child
There are even more reasons for the appearance of red spots on the legs and other parts of the body in young children than in adults. Mosquito bites are added to those already listed above ( in children they cause a large red spot that may not go away for up to two weeks), problems with digestion, kidneys or pancreas.For a baby, the spots may not cause any discomfort, but they may itch or burn. Very often, newborn babies develop toxic erythema. Another unpleasant disease for babies is pemphigus, in which spots are observed on the stomach and thighs. Pemphigus-related disease - Ritter's disease. It has a more severe course. But the primary foci of this disease should be looked for not on the legs, but on the baby’s face.
Allergies are the most common cause of red spots on a child's body and limbs. The skin may not only turn red, but also peel. Typically, severe allergies in children are caused by food products, but it is likely that the allergens are fabrics, dyes used in toys or bedding.
If a child eats only mother's milk, the mother should temporarily completely exclude all possible allergens from the diet ( citrus fruits, seafood and fish, eggs, chocolate, milk, red berries and fruits, and much more).
Blue spots
Blue spots or bruises on the legs sometimes appear seemingly for no reason. However, there must be a reason for this phenomenon.Here are the possible options:
- a blood disorder affecting the platelet count is the most serious reason, which can cause bruising on the legs. It is necessary to detect it, for this you should take a general blood test and a coagulogram,
- the vessels are close to the surface of the skin,
- lack of certain vitamins ( vitamin C, rutin),
- diseases of the liver, heart or blood vessels,
- stress,
- unbalanced diet.
Stains after hair removal
For many women, using an electroepilator causes red spots to appear on their legs, called pseudofolliculosis. Sometimes the cause of red spots is hairs that grow back after epilation, but do not rush upward, but get stuck between the layers of skin. If such a hair is not detected in time, a red spot appears, and later an abscess. Then the woman takes a needle and picks out the hair, which intensifies the inflammatory process. Such minor inflammations provoke increased melanin production. Pigment spots are already appearing.
To prevent this from happening, you must first make sure that the hair does not grow ingrown. To do this, scrubs are used, which need to be thoroughly scrubbed at least once a week. They should be washed with a massage sponge and rubbed sparingly. This procedure immediately “kills two birds with one stone”: excess layers of skin are removed and blood flow in the extremities improves. You can try using special means to reduce ingrown hairs.
To prevent red spots from appearing on your legs after epilation, you need to thoroughly sterilize the surface of your legs and the epilator before the procedure.
Spots and diabetes
The appearance of spots in diabetes mellitus is called dermopathy and is a fairly common symptom of the disease. Brown-red small spots up to a centimeter in diameter appear on the front surface of the legs. The interesting thing is that they appear symmetrically on both legs. Gradually they become larger and degenerate into atrophic dark spots. This symptom is more typical for representatives of the stronger sex; patients with diabetes are already quite long time. This symptom develops against the background of a violation of the condition of skin microcapillaries.Diabetic xanthoma- These are yellow spots that appear on the inner surfaces of the knees, as well as the neck, chest and face. The cause of these spots is increased cholesterol levels in the blood.
Diabetic bubble- These are blisters that appear on the feet, as well as the toes and hands. They appear suddenly, without any preliminary symptoms. This symptom is observed quite rarely. The spots go away on their own in a month to a month and a half. Their size may vary.
Darier's granuloma annulare- This is a symptom more characteristic of men. Round, swollen pinkish spots appear on the legs, arms and body ( may be brighter), which increase in size, merge with each other and form patterns. The spots are raised along the edges. The spots appear periodically and do not go away for a long time. The impetus for their appearance may be the intake of sulfonamides and allergies.
Vitiligo is also common in diabetic patients.
Vascular spots can be removed with laser
Dilated vessels that form spots or stars are not uncommon. Healthy vessel should have an internal cross-section of approximately twenty microns in diameter. If its diameter is one hundred microns or more, it is called telangiectasia. Translated from Latin it means “expanded tip of the vessel.”The main cause of vascular spots is heredity. And the impetus for their development is liver disease, problems with blood clotting, and poor venous outflow. In many women, telangiectasias appear during pregnancy, while in others their number increases significantly during this period. In older people, the venous outflow of blood worsens, which is why vascular spots also appear.
There are also external phenomena that contribute to the appearance of vascular spots. These are injuries, ultraviolet abuse, frostbite, taking hormones or steroid drugs, radiation or deep peeling.
35 - 40% of the planet's inhabitants have vascular spots, but more often they appear in the fair sex. This is due to the hormones estrogens, which reduce the tone of the vascular wall, helping to increase their lumen.
It is almost impossible to get rid of vascular spots on the legs with the help of medications. A few years ago this was done only with the help of electrocoagulation. But this method causes unwanted side effects such as increased skin pigmentation.
Today, the most effective and safe method is a medical laser. The duration of the procedure is from five to fifteen minutes, it is completely harmless and comfortable for the patient. On average, it takes four to five sessions to remove stains, sometimes less.
How to remove age spots?
Pigment spots on the legs are a common occurrence. Women should know that from the age of 26 to 27, almost any scratch or pimple can cause the appearance of an age spot.To remove old age spots from the skin of the legs, you should use masks made from hydrogen peroxide and badyagi. You should take dry badyagu ( it is sold at the pharmacy), as well as three percent hydrogen peroxide. Mix these two substances to the consistency of thick sour cream. Take a shower and then treat the stained areas. You should keep it for a quarter of an hour, after which your feet should be washed thoroughly. During the procedure, the sensations will not be pleasant. It can sting quite hard. This recipe should not be used by people with allergies.
Even after the mixture has been removed, the discomfort will not go away for some time. The skin will turn red. If you make a mask every day for a week, the skin at the application sites will dry out and peel off like after a sunburn. To alleviate the condition of the skin, you can treat it with cosmetic oil or milk. During this period, sunbathing is strictly prohibited! Since the skin is still very tender and can burn.
Those who do not want to suffer like this should contact a cosmetologist. Pigment spots on the legs are burned out using a laser. In addition, diamond peeling is used. After stain removal, recovery takes up to 14 days. The procedure should not be postponed to the hot season. One procedure is enough to remove stains.
Which doctor should I contact for spots on my legs?
Since spots on the legs can appear for various reasons and, accordingly, be signs of various diseases, it is necessary to contact doctors of various specialties when they occur. Let's consider which doctors should be contacted for spots on the legs of a different nature and with different accompanying symptoms. It should be remembered that the final decision about which doctor to contact depends precisely on the nature of the spots and accompanying symptoms, since they allow one to suspect the disease that provoked them and, accordingly, understand which doctor of what specialty is involved in the diagnosis and treatment of this pathology. So, if the spots on the legs are of various sizes, red, pink, white, brown or yellowish, perhaps very itchy, wet, there are swelling and flakes of the skin, and there are no generalized signs of infection (fever, headache, lethargy, cough, runny nose, etc.) and pain deep in the tissues in the area of the spots, then this indicates skin pathology(lichen, leprosy, eczema, dermatitis, fungal skin infection, toxicoderma, psoriasis, pemphigus, etc.). In such a situation, you should contact dermatologist-venereologist (make an appointment).
If the spots on the skin are small, turning into any other formations (vesicles, crusts, pustules, etc.), and at the same time there are general symptoms of an infectious disease (temperature, headache, lethargy, general malaise, etc.), then you should contact infectious disease doctor (make an appointment) or therapist (make an appointment), since such a clinical picture may indicate a childhood infection (for example, measles, rubella, etc.).
If the spots on the skin of the legs are of various sizes, very swollen, itchy, possibly having the appearance of blisters, appear suddenly against the background of complete health, undergo changes over time (increase in size, turn into blisters, nodules, etc.) and are absent any other symptoms, this indicates an allergic reaction, in which case it is necessary to contact Allergist (make an appointment).
If the spots on the legs are small, not convex, do not merge with each other, do not itch and are very pale pink in color, so that they are very difficult to notice against the background of the normal color of the skin, or white, then this may indicate syphilis. In this case, you must contact venereologist (make an appointment).
If large dark spots (chloasma) appear on the legs and other parts of the body, or, on the contrary, some areas of the skin become completely white (vitiligo, leucoderma) without pigment, then you should contact endocrinologist (make an appointment), since such spots may be a sign of dysfunction of various internal secretion organs (thyroid gland, adrenal glands, liver).
If a flat or raised bumpy or nodular formation appears on the leg, hot to the touch, colored in various colors of red - from pale pink to burgundy-bluish, and increasing in size over time, and sometimes bleeding - hemangioma is suspected. In this case, you must contact surgeon (make an appointment).
If red spots appear in combination with pain and heaviness in the legs, and possibly bulging veins, then we are talking about varicose veins. In this case, you should contact phlebologist (make an appointment) or vascular surgeon(sign up).
If blue spots or bruises appear on the legs without a compelling and visible reason, this indicates a pathology of the blood system (anemia, bleeding disorder). In this case, you must contact Hematologist (make an appointment).
If there are multiple small burgundy or red spots on the legs - pinpoint hemorrhages, or the skin on the legs is covered with a burgundy-violet mesh, and the person is also bothered by pain in the muscles and joints, rashes on other parts of the body and other unclear symptoms from various organs , then you should contact rheumatologist (make an appointment), since such a picture indicates a systemic disease of connective tissue and blood vessels (vasculitis, lupus erythematosus, etc.).
If there are spider veins on the legs or veins are very visible through the skin, and also periodically or constantly there is a feeling of heaviness and pain in the right hypochondrium, decreased appetite, fatty foods are poorly tolerated, tormented by flatulence and bloating, then this may indicate liver disease. In this case, you should contact hepatologist (make an appointment) or gastroenterologist (make an appointment).
If spots on the legs appear in people suffering from diabetes, then you should contact an endocrinologist who will examine the formations and determine possible reason complications, after which, in turn, he will refer you to another specialist for consultation.
If suddenly a single, but rather large red spot appears on the leg, not increasing in size, painful in places, red at the edges and white or bluish in the center, combined with severe pain and cold feet, you should immediately call an ambulance, as similar condition may be a sign of deep vein thrombosis, which requires urgent medical intervention to save your life.
What tests and examinations can a doctor prescribe for spots on the legs?
Since spots on the legs are provoked various diseases, then the list of examinations prescribed when they appear may be different in each specific case. However, such lists can be conditionally combined into certain standard ones, which are used by a doctor of each specialty to diagnose pathology that is within the scope of his professional interests. Below we will look at what tests and examinations a doctor of each specialty can prescribe for diagnosis various pathologies depending on the clinical symptoms a person has, in addition to spots on the legs.
When spots of various sizes, red, pink, white, brown or yellowish in color appear on the legs, which may itch, become wet, have swelling and scaly skin, and there are no generalized signs of infection (fever, headache, lethargy, cough, runny nose, etc.) and pain in the depths of the tissues in the area of the spots, this indicates a skin pathology (lichen, leprosy, eczema, dermatitis, fungal skin infection, toxicoderma, psoriasis, pemphigus, etc.). In this case, the doctor prescribes and conducts the following tests and examinations:
- General blood test (sign up);
- General urine analysis ;
- Biochemical blood test (sign up);
- Blood test for syphilis (sign up);
- Blood test for the concentration of immunoglobulins in the blood (sign up);
- Coagulogram (blood clotting) (sign up);
- Blood for the reaction of blast transformation of lymphocytes (RBTL);
- Feces on worm eggs;
- Dermoscopy (examination of spots using a magnifying glass with 20x magnification);
- Vitropression (pressure on a stain with a watch glass, staple or glass slide);
- A scraping or smear - an impression of the stains, followed by examination under a microscope;
- Bacteriological seeding of discharged stains onto the medium;
- Allergic skin tests (sign up);
- Scraping of stains and inspection of the resulting defect;
- Inspection of stains under Wood's lamp;
- Transillumination (inspection of spots in a darkened room under oblique rays of light);
- Detection of viruses in the contents of vesicles using the method PCR (sign up) or the Tzanck reaction;
- Blood culture for sterility.
When the spots on the legs are small, turning into some other formations (vesicles, crusts, pustules, etc.), and at the same time there are the same spots on other parts of the body and general symptoms of an infectious disease (fever, headache , lethargy, general malaise, etc.) – the doctor diagnoses any infection (measles, rubella, etc.) that occurs with damage to the skin and blood vessels. In this case, usually no additional special studies are prescribed, since diagnosis is carried out on the basis of characteristic symptoms. But to assess the general condition of the body, the doctor may prescribe a general blood and urine test, as well as biochemical analysis blood and blood clotting tests.
When the spots on the legs are of different sizes, are very itchy, swollen, are also localized on other parts of the body, may have the appearance of blisters, appear suddenly against the background of complete health, change over time (increase in size, turn into blisters, nodules, etc. ), and there are no other symptoms - the allergic nature of the skin lesion is suspected. In this case, the doctor prescribes the following tests:
- General blood analysis;
- Blood test for IgE concentration;
- Skin allergy tests by prick test or scarification;
- Analysis of hypersensitivity to various allergens by determining the concentration of specific IgE in the blood (on guinea pig, rabbit, hamster, rat, mouse, latex, orange, kiwi, mango, pineapple, banana, apple, peach, common ragweed, wormwood, white pigweed, plantain, Russian thistle, sweet spikelet, perennial rye, timothy, cultivated rye, woolly milkweed, house dust and house dust mites);
- Reaction of basophil degranulation, blast transformation of lymphocytes, agglomeration of leukocytes (usually when toxicoderma is suspected).
The doctor usually prescribes a general blood test and allergy skin tests to find out which substance the body is sensitive to. increased sensitivity. These tests are sufficient for diagnosis in the vast majority of cases, so they are the most common and widely used. However, if the doctor suspects that the body's reaction to skin allergy tests (sign up) turns out to be too strong, and this will worsen the condition, then identification of sensitivity to various allergens is prescribed either by measuring the concentration of specific IgE in the blood, or by the results of the reaction of basophil degranulation, blast transformation of lymphocytes, agglomeration of leukocytes. When there are small, non-convex spots on the legs and, possibly, other parts of the body, not merging with each other, not itchy, colored either white or pale pink color, so that they are very difficult to notice against the background of normal skin coloring - the doctor suspects syphilis and prescribes a blood test for the presence of causative agents of this infection. In this case, the causative agent of syphilis ( treponema pallidum) is determined in the patient’s blood by several methods.
When there are large dark spots (chloasma) on the legs and other parts of the body, or, on the contrary, some areas of the skin become completely white (vitiligo, leucoderma) without pigment, this indicates a disruption in the functioning of the internal secretion organs (thyroid, adrenal glands) and liver . In this case, the doctor prescribes the following tests and examinations:
sign up) ;
When there is a flat or raised bumpy or nodular formation on the leg that is hot to the touch, colored in various colors of red - from pale pink to burgundy-bluish, and sometimes bleeding - a hemangioma is diagnosed. In this case, the doctor must prescribe a blood clotting test and platelet count to differentiate the disease from Kasabach-Merritt syndrome. To determine the depth of tumor germination and the degree of damage to the underlying structures, an ultrasound scan of the hemangioma is performed, and to assess the blood supply to the tumor, a angiography (sign up). However, for hemangioma, only a blood clotting test with platelet count can be prescribed, since these tests are quite sufficient to distinguish the tumor from a similar pathology, and the diagnosis itself is made based on examination. A Ultrasound (sign up) and angiography may not be prescribed.
When red spots appear on one or both legs in combination with heaviness and pain in the legs, and possibly bulging veins, a diagnosis of varicose veins is made. In principle, no tests or examinations may be prescribed, since the diagnosis is obvious based on external, visible symptoms. However, to assess blood flow in the affected vessels, the doctor may prescribe duplex angioscanning, Doppler ultrasound, or rheovasography (sign up). These examinations are necessary to assess the severity of varicose veins and predict complications.
When blue spots or bruises often form on the skin without a compelling and visible reason, a blood system disease (anemia, bleeding disorder) is suspected. In this case, the doctor prescribes the following tests and examinations:
- Complete blood count with platelet count and leukoformula (sign up);
- Analysis to determine platelet morphology;
- Blood test for coagulation (coagulogram);
- Bone marrow puncture (make an appointment) with the preparation of smears and counting of hematopoietic stem cells;
- Test for antibodies to platelets in the blood;
- Ultrasound of the spleen (sign up), liver and other organs;
- Tomography of the abdominal organs.
When multiple small burgundy or red spots appear on the legs - pinpoint hemorrhages, or the skin is covered with a sort of burgundy-violet mesh, pain in the muscles and joints, rashes on other parts of the body and various symptoms from any other organs are also disturbing, the doctor suspects a systemic connective tissue and vascular disease (vasculitis, systemic lupus erythematosus, etc.) and prescribes the following tests:
- General blood analysis;
- Blood clotting test;
- Analysis for the number of circulating immune complexes (CIC) in the blood;
- Blood chemistry;
- Rheumatoid factor in the blood (sign up);
- Determination of the amount of immunoglobulins in the blood;
- C-reactive protein;
- Antikeratin antibodies in the blood;
- Antibodies to double-stranded DNA (anti-dsDNA-AT);
- Antibodies to histone proteins;
- Analysis for LE cells in the blood;
- Antibodies to phospholipids (lupus anticoagulant, antibodies to cardiolipin (sign up), positive Wasserman reaction (sign up) with a confirmed absence of syphilis);
- Antibodies to coagulation factors VIII, IX and XII;
- Test for antinuclear factor (ANF) in the blood;
- Skin biopsy;
- Vascular ultrasound (sign up) And internal organs (hearts (sign up), kidney (sign up), liver, etc.);
- Dopplerography of blood vessels (sign up);
- Duplex angioscanning of blood vessels;
- ECG (sign up).
When spider veins or translucent veins are visible on the legs, heaviness and pain in the right hypochondrium are periodically or constantly felt, appetite is reduced, fatty foods are poorly tolerated, flatulence and bloating are tormented - liver disease is suspected, and the doctor prescribes the following tests and examinations:
- General blood analysis;
- General urine analysis;
- The number of platelets in the blood;
- Blood test for hepatitis A, B, C and D viruses (sign up);
- Blood test for immunoglobulin levels;
- Blood clotting test (coagulogram);
- Biochemical blood test (total protein, albumin, bilirubin, urea, creatinine, potassium, sodium, chlorine, calcium, AST and ALT activity, alkaline phosphatase);
- Ultrasound of the liver;
- Tomography (computed or magnetic resonance imaging (sign up));
- Liver biopsy (to sign up).
