Confused

Hi,
I am having a hard time researching whether the red dots that show up on your body that may indicate disease are flat looking or are they also bumpy looking like pimples. I have read some contradictory articles that say they look flat and not bumpy and some articles that say they can be flat and bumpy. I'm confused. Also, I have used cortosteroids for my palmoplantar pustulosis on my hands and my feet for years. Now that my swelling has gone down I noticed that the skin pigmentation looks red to purple on my feet like bruising and red on my hands. My platelets are down to 106,000. I am wondering whether continued use of topical cortosteroid creams can cause changes in your skin pigmentation which could look like bruising and if so should bruising hurt when you have ITP. In my case they have classified me with ITP since my platelet count is below 150,000.
Any comments from the community would be appreciated, Maronese

With long-term use of topical steroid the skin may develop permanent stretch marks (striae), bruising, discolouration, or thin spidery blood vessels (telangiectasias).
Topical steroids may trigger or worsen other skin disorders such as acne, rosacea and perioral dermatitis.
Skin colour may change. This is more noticeable if you have dark skin. from patient.info/health/topical-steroids-for-eczema .

Never had petechia so cannot comment.

I have to say with a count of 106 you may be worrying unnecessarily. ITP treatment is rarely instigated until count is below 30

See www.ebmt.org/Contents/Resources/Library/Resourcesfornurses/Documents/ITP%20Handbook.PDF
>50 No treatment
30–50 No treatment or prednisone (1–1.5 mg/kg/day) for patients at higher risk of haemorrhage (e.g. hypertensive, lifestyle factors, concomitant medication use, head trauma or scheduled for surgery)
<30 Prednisone (1–1.5 mg/kg/day)
Haemorrhage or life- threatening bleed
Emergency treatment:
Platelet transfusion
Intravenous immunoglobulin (IVIg; 1 g/kg/day for 2–3 days) Methylprednisolone (1 g/day for 3 days)

Petechiae are always flat and red. They are very small like pin prick marks. They can appear alone or in clusters.
Mrs. B is right about the topical steroid creams. Oral steroids can do that as well. I have purpleish colors on my knees and other areas of my legs from long term steroid use. All of these drugs that are used to treat autoimmune disorders can cause nasty side effects, especially is used long-term.