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October 1992

Flushing Reactions in the Cancer Chemotherapy Patient: The Lists Are Longer but the Strategies Are the Same

Author Affiliations

Departments of Medicine and Pharmacology The Ohio State University 4731 UHC 456 W 10th Ave Columbus, OH 43210-1282

Arch Dermatol. 1992;128(10):1387-1389. doi:10.1001/archderm.1992.01680200097016

Flushing is a transient reddening of the face and frequently other areas, including the neck, the upper chest, and epigastric area.1 Despite the limited cutaneous distribution, many of the agents that provoke flushing are systemic and lead to increases in skin blood flow at both malar and forearm sites.2 Both a greater capacitance in the facial cutaneous vasculature and a cluster of optical phenomena, such as wider vascular diameters, vessels nearer the surface, and less tissue fluid obscuring the vessels, account for the limited distribution of flushing.2

Since flushing is a phenomenon of transient, usually systemic, vasodilation, it is useful to understand the dual control of vascular smooth muscle by nerves and circulating agents.3 Thus, flushing mechanisms may be broadly classified into those due to direct action of the circulating agents and those mediated by nerves. Autonomic nerves also control the eccrine sweat glands so that