Hello, sorry to hear about Butters. I think those are his elbows?? If so, this can be the early development of a callus, commonly seen in dogs as they age because of the pressure point at the skin of the elbow that is created especially when dogs are laying down. Alternatively, this could be comedones that can be seen with skin allergies or local skin irritation. If Butters does not seem to be bothered by them, is not licking them, scratching, or lozing hair then you can monitor the area for any of those signs. If he is showing signs, then he could be having allergies and you should consider having your veterinarian examine the areas to see if he needs to be further evaluated for allergies and determine if he needs to be treated for these. Hope this helps and best of luck.