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Nov 2011

A Rare Cause of Acquired Telangiectases Extending From the Feet to Arms —Quiz Case

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; SENAIT W. DYSON, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD

Arch Dermatol. 2011;147(11):1317-1322. doi:10.1001/archdermatol.2011.352-a

A 70-year-old white man presented extensive acquired telangiectases. The medical history included obesity (body mass index, 34 [calculated as weight in kilograms divided by height in meters squared]), previous smoking, chronic obstructive bronchitis, sleep apnea, and arterial insufficiency. The patient received 2 inhaled bronchodilators and clopidogrel. Lesions had first appeared 10 years previously, with progressive ascending extension. Dermatological examination revealed diffuse, bilateral, symmetric telangiectases on the arms, hands, abdomen, thighs, legs, and feet associated with varicose veins on the distal part of the lower limbs (Figure 1) but no mucosal or lip involvement. The health of the patient was otherwise normal, with no signs of thyroid, cardiac, or digestive impairment and no abnormal lymph node findings. Results of laboratory investigations, including testing for vascular endothelial growth factor and tryptase, were normal. Chest radiography and cervical and thoraco-abdominal computed tomography scans gave normal results. Skin biopsies were performed on the trunk (Figure 2 and Figure 3).

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