A woman in her 50s presented with “speckled” red lesions on her bilateral arms, lower legs, and feet. They had first appeared on her lower legs 15 years ago and were slowly increasing in number and spreading to involve her feet and bilateral upper extremities. The patient denied tenderness, pruritus, and edema. She reported no family history of this problem and denied any personal history of anemia, epistaxis, hematemesis, melena, hematochezia, or hemoptysis. She had a medical history of hypertension, hyperlipidemia, and tobacco abuse, requiring treatment with losartan and atorvastatin.
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A nice review of GET, however the treatment discussion lacks perspective. In reality, vascular laser works very well. My experience with 595nm Pulsed Dye Laser for this condition demonstrates very high response rates at the lower end of the fluence range. I suspect than any vascular laser or IPL operating in the 500 to 600 nm range with a large treatment spot size would be effective. In summary, vascular laser is the treatment of choice and the bizarre collection of medications that have been tried are simply an historical curiosity.
Hunt KM, Kissel R, Seminario-Vidal L. Progressive Widespread Cutaneous Telangiectasias. JAMA Dermatol. 2014;150(10):1103–1104. doi:10.1001/jamadermatol.2014.1183
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