Generalized Essential Telangiectasia Clinical Presentation

Updated: Dec 15, 2017
  • Author: David Green, MD, PA; Chief Editor: Dirk M Elston, MD  more...
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Presentation

History

The most commonly observed initial clinical presentation of generalized essential telangiectasia is telangiectasia on the feet, ankles, and distal legs. Subsequently, telangiectases appear more proximally on the lower extremities, and they also may develop on the upper extremities and trunk. In a report of 13 patients, 12 had involvement of the lower extremities. Occasionally, telangiectases first become apparent on the upper extremities or trunk. [3]

Bleeding from the ectatic vessels is rare.

Usually, no family history exists of a similar disorder; however, some familial cases have been reported.

Generalized essential telangiectasia is usually asymptomatic, but tingling burning or numbness is occasionally reported.

The age of onset is usually in the fourth or fifth decade, but symptoms may be observed in younger adults.

The progressive development of the telangiectases, without spontaneous regression, is the usual course.

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Physical Examination

In generalized essential telangiectasia, dilated blood vessels represent capillary telangiectases (not venous), ie, they appear red or pink and are usually less than 0.2 mm in diameter, unlike venous telangiectases, which usually appear more blue in color and are greater than 0.2 mm in diameter.

Most often, generalized essential telangiectasia presents as numerous discrete pink and red capillaries, appearing punctate, linear, or as a lacework or syncytial network. Occasionally, discrete, well-circumscribed, red macules lend the skin a speckled appearance, as shown in the image below.

Essential generalized telangiectasia. Courtesy of Essential generalized telangiectasia. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/assets/Uploads/vascular/ess-telang1.jpg).

Capillaries are usually bilateral and are symmetrically distributed on the skin. When they are numerous enough to become confluent, the skin appears diffusely erythematous, and discerning individual telangiectases becomes impossible.

Telangiectases rarely protrude above the normal plane of the skin. Pressure on the skin readily displaces the blood, causing blanching; however, rapid refilling occurs.

On infrared photography, the underlying venous vasculature appears normal.

Even in the presence of significant cutaneous involvement, mucous membranes and conjunctivae are not usually affected, although extracutaneous involvement of the oral mucosa and conjunctiva has been reported. [9, 10, 11, 12, 13] No changes occur within the epidermis or dermis.

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Complications

No physical complications are associated with generalized essential telangiectasia; however, the diffuse nature of the capillary telangiectases can be a source of emotional distress to patients. [14]

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