Does anyone suffer from pathergy in the form of the blackening of skin cells?

Summer last year I went to a gynae as I had noticed a series of black marks on my labia. It almost looked as in someone had taken a felt pen and scribbled on my bits.

After a multiple site biopsy for suspected carcenoma, I was given the all-clear. However, the black marks duly reappeared.

Behcets Consultant diagnosed this as pathergy with my body reacting against the biopsy itself. I have no particular reason to doubt him, but, some 12 months later (with no further intrusions to my body in that particular area) I am suffering from these black pigmentations once again. So much so that I would describe my labia as looking bruised or almost dead.

I know pathergy can take a number of forms so I suppose I was wondering if anyone else had suffered a similar thing?

It's completely symptom free in real terms but I can't help but worry that it is something more serious that we are signing off as part of behcets.

Thanks all

4 Replies

  • Hello,

    I think I know what you are describing-- I noticed about two years ago or so that I had a couple of small blotches of darkened skin (almost a black colour) on my labia major and one on the labia minor. I didn't think too much of it because my skin has taken a true beating over the years from the Behcet's, and I've had so many different skin rashes, lesions, ulcers, blisters, and markings, that I could probably fill an entire large dermatology textbook with all of them. The area was burning, so I took a peak and found these markings, along with a couple of raw ulcers (not in the exact same place though). I decided to just keep an eye on the marks, and overtime, they seemed to lighten a bit, but have remained there. Since then I've had a couple new dark blotches appear on my labia again, but these ones faded. I'm not sure if they are the same thing--but I have also had dark blotches appear on other areas of my skin as well; about five years ago, a round blackish-purple blotch appeared on my cheek-- it looked bruised around it and felt bruised when I touched it. Eventually the bruising and pain disappeared, but the dark spot remained. It finally just faded and disappeared about a year ago. I have also had this happen on my arm and on my legs. I have never had them examined by a dermatologist as I just figured they were a "normal" skin lesion as part of Behcet's, and also because they don't usually bother me too much unless a bruise or ulcer comes with it. As long as you've been cleared of anything serious, then I would just assume that yours are probably the same thing-- just another pathergy of the skin. Its crazy how such little things as a mark on the skin can actually turn out to be a common skin lesion from this disease. It sure has helped me to see questions like yours, and it turns out that I have similar issues-- just to know I'm not weird or anything and that I'm not alone, it definitely does help.


  • Hi Hun,

    I can remember quite a few years ago that I had problems in the areas you describe in the form of multiple black spots like someone had got a black ink marker and just dotted all the area until it looked like something from a 'dot to dot' puzzle. lol.

    It was long before my diagnosis for BD and my GP at the time had a good look and was totally baffled and said at close inspection (something I couldn't do for myself as I am not a contortionist) it looked almost like small dark blood blisters but loads and loads of them all at once and the size of a pin head.

    She wondered if I had come in contact with something I was allergic to but now I know it was related to BD having described it to my specialist as it occurred probably another 3 times in 15 years. It lasted about 4-5 weeks and went away on it's own so he said it was some type of vascullitis that was affecting the very tiny ends of the blood vessels in that area but didn't know why it had occurred. He didn't view it as anything to be particularly worried about just very curious to see so I didn't worry about it too much after that.

    As with all things like this hun, it may sound the same and this may be comforting to you but if you are at all concerned then get it checked out as there are so many things that look and sound the same and we, as amateurs, have no real expertise in deciding if what we are describing is in fact the same thing.

    Tootles xx :)

  • Yes I do.

    I get vascular lesions that start where a vein punches out an ulcer through my skin. I could not understand why my skin went completely black, it is quite frightening...I don't have an exact photo of it, but this is how it happens.

    Area might become inflamed, rapidly expanding and swelling, and redness.

    The skin immediately above the actual vein in question starts to go blue.

    the blueness forms a perfect circle on the skin, and may start to look a bit like a blister.

    The blue turns to black, and the flesh and skin where it is black just disintegrates and rots into a hole, often with a sinus track which goes along the vein.

    A surgeon once got a 24 inch (or possibly longer) piece of wire, then pushed it into the hole to see how far it would go....and the answer was quite a long way.

    Often, if the skin heals it is very scarred and never the same over a punched out ulcer.

    If it heals well, you are likely to get a really hard crusty plug of scab called eschar and will look like these photos if I am lucky:

    If you follow that link, it is my search of images for eschar skin lesion. Most are perfectly round, and most vascular ulcers form in that way. The black plug is a good thing.

    The black skin, that rots away to nothing with no scab leaving an open wound is a bad thing. What happened to me is I started with small holes like the ones you see on folks pics above, but the edges of it got more and more black and spread across the surface of a limb, often about 5 inches or more in diameter, and in some places as deep as the bone sheath with tendons exposed....this is very unusual and in me happened rapidly. Obviously, by losing chunks, I did get veins dying off and nerves disconnecting.

    The body is an amazing thing though. In one place, where my brachial veins were gone in the elbow, a new vein grew over years and has a diverted kink to go the long way around the place where there was a thrombosis.

    Black can be a sign of skin cells dying off, and means there is not a good blood supply there.

    In some cases, gangrene can show as black or grey but that smells horrendous and obviously is rotting. Other bacterial infections can cause skin to die off.

    Also, it can be a sign of carcenoma but there are many conditions that mimic carcenoma, that look black, e.g. a harmatoma (this is not to be confused with a haematoma) and I have seen these pop up all over my white dog, including hairless parts. They are slightly raised on my dog and look exactly like someone scribbled with a black marker....these can form on humans and are benign but annoying.

    You can also get seborrheic keratosis, that goes black or dark... and can be flat or raised.

    Some people get hyperpigmentation after any kind of inflammation and I learned today, that some places where both myself, and my dogs, broke out in sores has gone like a black mark or freckles, often large and irregular...the vet said it was typical of post folliculitis inflammations and skin scrapes showed my dogs at least were not cancerous...These can occur on labia, especially if you have stray hairs that try to grow around edges of bits....all these things can be examined under microscope to rule out any bugs, infections, and can be scraped and biopsied to classify them...which anybody should do, regardless of what it looks like.

    One thing I noticed from some of my rapid blue black skin dying off, is that where it happened was relatively painless. It was only painful just before it happened and was enormously swollen, and in flesh that still had red bits attached. It was painful around the edges, where it was spreading. It was often painful a long long time afterwards, due to nerve damage and compression by scar tissue forming.

    Some of the black marks on my arms that did not cave in like above, faded to freckles. I do have one or two of those type of freckle marks on my labia, and they do seem to be where a hair tried to grow then got really painful around the base of the hair which died off and dropped out. That seems typical of folliculitis, or seborrheic inflammation as I can get quite sweaty if feverish.

    Do you remember if there was any hair growing near or around those areas?

    If not, did you ever get sebacious raised type cysts, mainly flat and very white? and def not genital warts (they still tried to burn them off daily with me, and then decided they were part of me and not actually a virus at all!). That area is really rich in sebacious glands, and those can become inflamed.

  • I to am terribly scarred with these ugly black/purple marks. Mine are the end result of genital sores (which have a 'crater' like appearance) and do nothing other than cause pain/embarrassment and black scars as a reminder!

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