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Tiny red pinpoint dots under the surface of the skin may be petechiae or vasculitis of smaller blood vessels. I was diagnosed with ITP (another AI disorder that destroys platelets in the blood and makes it difficult for the body to stop bleeding) years ago after many months of unexplained bruising and then rashes of petechiae.
Petechiae usually occur when platelet levels in the blood are low; they are small areas under the skin where capillaries begin bleeding (happens all the time) but cannot stop bleeding as soon as usual. The petechiae themselves are not dangerous but could be a sign of low platelets, which might be of concern depending on HOW low they are (mine are typically low but haven't been dangerously low for years). Get to a physician as soon as possible to let him/her check out the spots and possibly order a simple blood test (CBC) to check your platelet level. If nothing else, this is good for peace of mind.
I recently began noticing more outbreaks of the pinpoints and went quickly to the doctor to get a CBC. However, the doctor felt that these other dots were vasculitis, a condition where (as best I can tell) the blood vessels under the skin become enlarged or in some other way move up closer to the surface of the skin in areas, making them visible to you. According to the doctor, this is not entirely uncommon and can occur for a variety of reasons. This symptom by itself usually isn't cause for concern.
If the spots are petechiae, they are more likely to occur in patches together, turn brown with time rather than stay red, and begin on the legs or feet. If the spots are vasculitis, however, they will remain bright red for a longer period of time, may be somewhat raised, and will blanch out (fade briefly) with pressure. I find it hard to see this effect using my finger and trying to pull it off in time to see the blanching, so I use a piece of glass (old eyeglass lens) to mash on the skin and watch through the glass to see if the spots fade.
It wouldn't hurt to see the doctor and request a CBC - like I said, it's great peace of mind and, in the event that the spots are petechiae, may allow you and your healthcare provider to give you better treatment.





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