DEAR DR. GOTT: I am a healthy 52-year-old female who has suffered from DSAP (disseminated superficial actinic porokeratosis) most of my adult life. I have hundreds of bright red spots on each arm and leg. Many people steer clear of me, thinking it’s some type of contagious disease, and many will say, “Oh, you’ve been in poison oak,” or something similar. I have to wear long pants in the summer, even at the beach.

There appears to be very little information about DSAP, and my dermatologist says that my case is one of the worst she’s ever seen. No treatment seems to help. I’ve used Retin-A, Efudex, and every other prescription cream and ointment that my dermatologist knows of. We even tried freezing them with liquid nitrogen. I have actually had as many as 25 done on each arm and leg at one office visit, but they inevitably come back. My spots are generally bright red and itch, and seem to be inflamed after exercise. Any type of lotion makes them even redder.
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