bier spots bier spots bier spots are small, light macules usually found on the arms and legs of young adults, in which the intervening skin may seem erythematous but blanches with pressure so that these light macules disappear.: 863 this is a benign physiologic vascular anomaly of no significance clinically.: 863 : 819–20 hand with multiple bier spots diagnosis the spots appear when the blood is congested with a bandage on the upper arm, e.g. with a blood pressure cuff. the spots also appear when the arms are slightly raised from the trunk (angle approx. 45°) and disappear again when the arms are stretched upwards. treatment it is a physiological phenomenon that requires no treatment.