SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD; LORI D. PROK, MD
A healthy 24-year-old white woman presented with telangiectases of the distal lower extremities. The first of the lesions appeared 3 years prior to the encounter as a small focal telangiectasia on the left ankle. Since then, this lesion enlarged significantly, and other telangiectases developed on the patient's other ankle and on the dorsal aspects of the feet bilaterally. The telangiectases themselves were asymptomatic, causing no pain or pruritus, but there were associated paresthesia and Raynaud phenomenon of both feet. The patient denied a history of bleeding or seizure disorders, had no other medical conditions or pertinent family history, and was taking no medications. On physical examination, there were symmetric patches of telangiectases on the anterior ankles (Figure 1) and dorsa of the feet bilaterally. There were no petechiae, ulcerations, nail changes, or mucous membrane involvement. Biopsy specimens were obtained from the affected areas (Figure 2 and Figure 3).
Word AP, Jackson ML, Costner M, Cockerell CJ, Sinkre PA. Telangiectases of the Distal Lower Extremities Associated With Paresthesia and Raynaud Phenomenon—Quiz Case. JAMA Dermatol. 2013;149(1):97. doi:10.1001/2013.jamadermatol.17a