Cutaneous patterns of acquired generalized telangiectasia sometimes exist without associated systemic disease. They have been recognized heretofore and have been called "essential telangiectasia." Analysis of the clinical features in 13 cases reveals that the disease is much more common among women; the average age at onset is 38 years; and the development of the lesions is gradual. The lesions persist indefinitely throughout many years without effect on the general health of the patient. The clinical patterns may be diffuse or localized, macular, plaque-like or retiform, and discrete or confluent. Microscopic study reveals thin-walled ectatic vessels in the upper part of the corium in which alkaline phosphatase activity is not demonstrable. In contrast, the telangiectatic vessels of dermatomyositis do exhibit alkaline phosphatase activity. The evidence suggests that essential telangiectasia can be differentiated histochemically from symptomatic telangiectasia on the basis of alkaline phosphatase activity.
McGrae JD, Winkelmann RK. Generalized Essential TelangiectasiaReport of a Clinical and Histochemical Study of 13 Patients with Acquired Cutaneous Lesions. JAMA. 1963;185(12):909–913. doi:10.1001/jama.1963.03060120019015
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