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Review
. 2016 Sep;17(3):373-380.
doi: 10.1007/s11154-016-9394-8.

Flushing in (neuro)endocrinology

Fady Hannah-Shmouni  1 , Constantine A Stratakis  2 , Christian A Koch  3   4
Affiliations
Review

Flushing in (neuro)endocrinology

Fady Hannah-Shmouni et al. Rev Endocr Metab Disord. 2016 Sep.

Abstract

Cutaneous flushing is a common presenting complaint in endocrine disorders. The pathophysiology of flushing involves changes in cutaneous blood flow triggered by multiple intrinsic factors that are either related to physiology or disease. Flushing can be divided into episodic or persistent causes. Episodic flushing is mediated by the release of endogenous vasoactive mediators or medications, while persistent flushing results in a fixed facial erythema with telangiectasia and cyanosis due to slow-flowing deoxygenated blood in large cutaneous blood vessels. The differential diagnosis of cutaneous flushing in neuroendocrine disorders is limited, yet encompasses a broad spectrum of benign and malignant entities, including carcinoid syndrome, pheochromocytoma, Cushing syndrome, medullary thyroid cancer, and pancreatic neuroendocrine tumors. In this review, we provide a concise and up-to-date discussion on the differential diagnosis and approach of flushing in neuroendocrinology.

Keywords: Carcinoid; Flushing; Histamine; Neuroendocrine tumor; Pheochromocytoma; Substance P.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Image 1
Image 1
Flushing from a carcinoid tumour in the foregut due to histamine release. With permission from John Wiley and Sons
Image 2
Image 2
Facial plethora in a patient with Cushing syndrome before and after surgery. With permission from Ali Afshari and Constantine A. Stratakis, NIH
See this image and copyright information in PMC

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References

    1. Ikizoglu G. Red face revisited: flushing. Clinic in Dermatology. 2014;32:800–808. - PubMed
    1. Ray D, Williams G. Pathophysiological causes and clinical significance of flushing. Br J Hosp Med. 1993;50:594–8. - PubMed
    1. Aldrich LB, Moattari AR, Vinik AI. Distinguishing features of idiopathic flushing and carcinoid syndrome. Arch Intern Med. 1988;148:2614–8. - PubMed
    1. Metcalfe DD. Differential diagnosis of the patient with unexplained flushing/anaphylaxis. Allergy Asthma Proc. 2000;21:21–4. - PubMed
    1. Hartmann K, Escribano L, Grattan C, Brockow K, Carter MC, Alvarez-Twose I, et al. Cutaneous manifestations in patients with mastocytosis: consensus report of the European Competence Network on Mastocytosis, the American Academy of Allergy, Asthma & Immunology, and the European Academy of Allergology and Clinical Immunology. J Allergy Clin Immunol. 2016 Jan;137(1):35–45. - PubMed

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