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Clinical Investigations

Free Access

Palmar Telangiectasias: A Cutaneous Sign for Smoking

Levi A.a, b · Shechter R.c · Lapidoth M.a, b · Enk C.D.c

Author affiliations

aPhotodermatosis Clinic and Laser Unit, Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Petah Tikva, bSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, and cDepartment of Dermatology, Hadassah Medical Organization - The Hebrew University Medical School, Jerusalem, Israel

Corresponding Author

Assi Levi

Photodermatosis Clinic and Laser Unit, Department of Dermatology

Rabin Medical Center, Beilinson Hospital

39, Ze'ev Jabotinsky Rd, Petah Tikva, 4941492 (Israel)

E-Mail docalevi@gmail.com

Related Articles for ""

Dermatology 2017;233:390–395

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Abstract

Background: Telangiectasias are permanent dilations of blood capillaries which appear in a variety of medical conditions. Cutaneous palmar telangiectasias have been postulated to be associated with smoking. Objective: To determine whether a significant correlation exists between palmar telangiectasias and smoking habits. Patients and Methods: A total of 124 volunteers participated in this observational study by allowing physical evaluation of their palms and by completing a questionnaire. Results: Palmar telangiectasias were found to be associated with current or past smoking. Neither age nor gender was found to be a co-contributor. Discussion: Palmar telangiectasias were found to constitute highly specific and sensitive markers for prolonged smoking.

© 2017 S. Karger AG, Basel


References

  1. Brown GR: Cutaneous telangiectasias on lips and extremities. Arch Intern Med 1963;112:889-891.
  2. Alam MA, Sami S, Babu S: Successful treatment of bleeding gastro-intestinal angiodysplasia in hereditary haemorrhagic telangiectasia with thalidomide. BMJ Case Rep 2011;2011:bcr0820114585.
  3. Guedes R, Leite L: Unilateral nevoid telangiectasia: a rare disease? Indian J Dermatol 2012;57:138-140.
  4. Gordon Spratt EA, DeFelice T, O'Reilly K, Robinson M, Patel RR, Sanchez M: Generalized essential telangiectasia. Dermatol Online J 2012;18:13.
  5. Kalisiak MS, Haber RM: Angioma serpiginosum with linear distribution: case report and review of the literature. J Cutan Med Surg 2008;12:180-183.
  6. Stern RS: Clinical practice. Treatment of photoaging. N Engl J Med 2004;350:1526-1534.
  7. Cheng B, Erdos D, Stanley RJ, Stoecker WV, Calcara DA, Gómez DD: Automatic detection of basal cell carcinoma using telangiectasia analysis in dermoscopy skin lesion images. Skin Res Technol 2011;17:278-287.
  8. Cribier B: Pathophysiology of rosacea: redness, telangiectasia, and rosacea. Ann Dermatol Venereol 2011;138(suppl 3):S184-S191.
  9. Tierney EP, Hanke CW: Treatment of Poikiloderma of Civatte with ablative fractional laser resurfacing: prospective study and review of the literature. J Drugs Dermatol 2009;8:527-534.
  10. Foldes EG: Pharmaceutical effect of contraceptive pills on the skin. Int J Clin Pharmacol Ther Toxicol 1988;26:356-359.
  11. Hameed AF: Steroid dermatitis resembling rosacea: a clinical evaluation of 75 patients. ISRN Dermatol 2013;2013:491376.
  12. Ehmann LM, Ruzicka T, Wollenberg A: Cutaneous side-effects of EGFR inhibitors and their management. Skin Therapy Lett 2011;16:1-3.
  13. Dourmishev LA, Dourmishev AL, Schwartz RA: Dermatomyositis: an association of gingival telangiectasias and anti Jo-1 antibody in the adult. Acta Dermatovenerol Alp Panonica Adriat 2007;16:67-72.
  14. Guinovart RM, Vicente A, Rovira C, Suñol M, González-Enseñat MA: Facial telangiectasia: an unusual manifestation of neonatal lupus erythematosus. Lupus 2012;21:552-555.
  15. Ghosh SK, Bandyopadhyay D, Biswas SK, Darung I: Mucocutaneous manifestations in patients with rheumatoid arthritis: a cross-sectional study from Eastern India. Indian J Dermatol 2017;62:411-417.
  16. Halachmi S, Gabari O, Cohen S, Koren R, Amitai DB, Lapidoth M: Telangiectasis in CREST syndrome and systemic sclerosis: correlation of clinical and pathological features with response to pulsed dye laser treatment. Lasers Med Sci 2014;29:137-140.
  17. Kaneko H, Kondo N: Clinical features of Bloom syndrome and function of the causative gene, BLM helicase. Expert Rev Mol Diagn 2004;4:393-401.
  18. Ambrose M, Gatti RA: Pathogenesis of ataxia-telangiectasia: the next generation of ATM functions. Blood 2013;121:4036-4045.
  19. Mei-Zahav M, Letarte M, Faughnan ME, Abdalla SA, Cymerman U, MacLusky IB: Symptomatic children with hereditary hemorrhagic telangiectasia: a pediatric center experience. Arch Pediatr Adolesc Med 2006;160:596-601.
  20. Henry F, Quatresooz P, Valverde-Lopez JC, Piérard GE: Blood vessel changes during pregnancy: a review. Am J Clin Dermatol 2006;7:65-69.
  21. Casadio R, Santi V, Mirici-Cappa F, Magini G, Cacciari M, Bernardi M, Trevisani F: Telangiectasia as a presenting sign of Graves' disease. Horm Res 2008;69:189-192.
  22. Capodicasa E, De Bellis F, Muscat C: The hepato-pulmonary-cutaneous syndrome: description of a case and suggestion of a unifying hypothesis. Case Rep Gastroenterol 2010;4:273-278.
  23. Hazin R, Abu-Rajab Tamimi TI, Abuzetun JY, Zein NN: Recognizing and treating cutaneous signs of liver disease. Cleve Clin J Med 2009;76:599-606.
  24. Wang G, Chen H, Yang Y, Wu K, Sun J: Telangiectasia macularis multiplex acquisita accompanied by hepatitis B infection. Australas J Dermatol 2017;58:e5-e7.
  25. Nabatian A, Suchter MF, Milgraum S: Palmar telangiectasias as a manifestation of Graves' disease. Cutis 2012;89:84-88.
  26. McArthur G, Firkin BG: Smoking - another cause of palmar erythema? Med J Aust 1992;156:71.
  27. Serrao R, Zirwas M, English JC: Palmar erythema. Am J Clin Dermatol 2007;8:347-356.
  28. Kennedy C, Bastiaens MT, Bajdik CD, Willemze R, Westendorp RG, Bouwes Bavinck JN: Effect of smoking and sun on the aging skin. J Invest Dermatol 2003;120:548-554.
  29. McRobert J: Smoking and its effects on the healing process of chronic wounds. Br J Community Nurs 2013;18:S20-S23.
  30. Armstrong AW, Harskamp CT, Dhillon JS, Armstrong EJ: Psoriasis and smoking: a systematic review and meta-analysis. Br J Dermatol 2014;170:304-301.
  31. Bernhard JD: Auspitz sign is not sensitive or specific for psoriasis. J Am Acad Dermatol 1990;22:1079-1081.
  32. Kadunce DP, Burr R, Gress R, Kanner R, Lyon JL, Zone JJ: Cigarette smoking: risk factor for premature facial wrinkling. Ann Intern Med 1991;114:840-844.
  33. Ernster VL, Grady D, Miike R, Black D, Selby J, Kerlikowske K: Facial wrinkling in men and women, by smoking status. Am J Public Health 1995;85:78-82.
  34. Monfrecola G, Riccio G, Savarese C, Posteraro G, Procaccini EM: The acute effect of smoking on cutaneous microcirculation blood flow in habitual smokers and nonsmokers. Dermatology 1998;197:115-118.
  35. Tur E, Yosipovitch G, Oren-Vulfs S: Chronic and acute effects of cigarette smoking on skin blood flow. Angiology 1992;43:328-335.
  36. Richardson D: Effects of tobacco smoke inhalation on capillary blood flow in human skin. Arch Environ Health 1987;42:19-25.
  37. Amichai B, Grunwald MH: Palmar telangiectasias and lung carcinoma: a possible association? J Eur Acad Dermatol Venereol 2002;16:185-186.

Article / Publication Details

First-Page Preview
Abstract of Clinical Investigations

Received: June 08, 2017
Accepted: September 25, 2017
Published online: December 07, 2017
Issue release date: February 2018

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 2

ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)

For additional information: https://www.karger.com/DRM

References

  1. Brown GR: Cutaneous telangiectasias on lips and extremities. Arch Intern Med 1963;112:889-891.
  2. Alam MA, Sami S, Babu S: Successful treatment of bleeding gastro-intestinal angiodysplasia in hereditary haemorrhagic telangiectasia with thalidomide. BMJ Case Rep 2011;2011:bcr0820114585.
  3. Guedes R, Leite L: Unilateral nevoid telangiectasia: a rare disease? Indian J Dermatol 2012;57:138-140.
  4. Gordon Spratt EA, DeFelice T, O'Reilly K, Robinson M, Patel RR, Sanchez M: Generalized essential telangiectasia. Dermatol Online J 2012;18:13.
  5. Kalisiak MS, Haber RM: Angioma serpiginosum with linear distribution: case report and review of the literature. J Cutan Med Surg 2008;12:180-183.
  6. Stern RS: Clinical practice. Treatment of photoaging. N Engl J Med 2004;350:1526-1534.
  7. Cheng B, Erdos D, Stanley RJ, Stoecker WV, Calcara DA, Gómez DD: Automatic detection of basal cell carcinoma using telangiectasia analysis in dermoscopy skin lesion images. Skin Res Technol 2011;17:278-287.
  8. Cribier B: Pathophysiology of rosacea: redness, telangiectasia, and rosacea. Ann Dermatol Venereol 2011;138(suppl 3):S184-S191.
  9. Tierney EP, Hanke CW: Treatment of Poikiloderma of Civatte with ablative fractional laser resurfacing: prospective study and review of the literature. J Drugs Dermatol 2009;8:527-534.
  10. Foldes EG: Pharmaceutical effect of contraceptive pills on the skin. Int J Clin Pharmacol Ther Toxicol 1988;26:356-359.
  11. Hameed AF: Steroid dermatitis resembling rosacea: a clinical evaluation of 75 patients. ISRN Dermatol 2013;2013:491376.
  12. Ehmann LM, Ruzicka T, Wollenberg A: Cutaneous side-effects of EGFR inhibitors and their management. Skin Therapy Lett 2011;16:1-3.
  13. Dourmishev LA, Dourmishev AL, Schwartz RA: Dermatomyositis: an association of gingival telangiectasias and anti Jo-1 antibody in the adult. Acta Dermatovenerol Alp Panonica Adriat 2007;16:67-72.
  14. Guinovart RM, Vicente A, Rovira C, Suñol M, González-Enseñat MA: Facial telangiectasia: an unusual manifestation of neonatal lupus erythematosus. Lupus 2012;21:552-555.
  15. Ghosh SK, Bandyopadhyay D, Biswas SK, Darung I: Mucocutaneous manifestations in patients with rheumatoid arthritis: a cross-sectional study from Eastern India. Indian J Dermatol 2017;62:411-417.
  16. Halachmi S, Gabari O, Cohen S, Koren R, Amitai DB, Lapidoth M: Telangiectasis in CREST syndrome and systemic sclerosis: correlation of clinical and pathological features with response to pulsed dye laser treatment. Lasers Med Sci 2014;29:137-140.
  17. Kaneko H, Kondo N: Clinical features of Bloom syndrome and function of the causative gene, BLM helicase. Expert Rev Mol Diagn 2004;4:393-401.
  18. Ambrose M, Gatti RA: Pathogenesis of ataxia-telangiectasia: the next generation of ATM functions. Blood 2013;121:4036-4045.
  19. Mei-Zahav M, Letarte M, Faughnan ME, Abdalla SA, Cymerman U, MacLusky IB: Symptomatic children with hereditary hemorrhagic telangiectasia: a pediatric center experience. Arch Pediatr Adolesc Med 2006;160:596-601.
  20. Henry F, Quatresooz P, Valverde-Lopez JC, Piérard GE: Blood vessel changes during pregnancy: a review. Am J Clin Dermatol 2006;7:65-69.
  21. Casadio R, Santi V, Mirici-Cappa F, Magini G, Cacciari M, Bernardi M, Trevisani F: Telangiectasia as a presenting sign of Graves' disease. Horm Res 2008;69:189-192.
  22. Capodicasa E, De Bellis F, Muscat C: The hepato-pulmonary-cutaneous syndrome: description of a case and suggestion of a unifying hypothesis. Case Rep Gastroenterol 2010;4:273-278.
  23. Hazin R, Abu-Rajab Tamimi TI, Abuzetun JY, Zein NN: Recognizing and treating cutaneous signs of liver disease. Cleve Clin J Med 2009;76:599-606.
  24. Wang G, Chen H, Yang Y, Wu K, Sun J: Telangiectasia macularis multiplex acquisita accompanied by hepatitis B infection. Australas J Dermatol 2017;58:e5-e7.
  25. Nabatian A, Suchter MF, Milgraum S: Palmar telangiectasias as a manifestation of Graves' disease. Cutis 2012;89:84-88.
  26. McArthur G, Firkin BG: Smoking - another cause of palmar erythema? Med J Aust 1992;156:71.
  27. Serrao R, Zirwas M, English JC: Palmar erythema. Am J Clin Dermatol 2007;8:347-356.
  28. Kennedy C, Bastiaens MT, Bajdik CD, Willemze R, Westendorp RG, Bouwes Bavinck JN: Effect of smoking and sun on the aging skin. J Invest Dermatol 2003;120:548-554.
  29. McRobert J: Smoking and its effects on the healing process of chronic wounds. Br J Community Nurs 2013;18:S20-S23.
  30. Armstrong AW, Harskamp CT, Dhillon JS, Armstrong EJ: Psoriasis and smoking: a systematic review and meta-analysis. Br J Dermatol 2014;170:304-301.
  31. Bernhard JD: Auspitz sign is not sensitive or specific for psoriasis. J Am Acad Dermatol 1990;22:1079-1081.
  32. Kadunce DP, Burr R, Gress R, Kanner R, Lyon JL, Zone JJ: Cigarette smoking: risk factor for premature facial wrinkling. Ann Intern Med 1991;114:840-844.
  33. Ernster VL, Grady D, Miike R, Black D, Selby J, Kerlikowske K: Facial wrinkling in men and women, by smoking status. Am J Public Health 1995;85:78-82.
  34. Monfrecola G, Riccio G, Savarese C, Posteraro G, Procaccini EM: The acute effect of smoking on cutaneous microcirculation blood flow in habitual smokers and nonsmokers. Dermatology 1998;197:115-118.
  35. Tur E, Yosipovitch G, Oren-Vulfs S: Chronic and acute effects of cigarette smoking on skin blood flow. Angiology 1992;43:328-335.
  36. Richardson D: Effects of tobacco smoke inhalation on capillary blood flow in human skin. Arch Environ Health 1987;42:19-25.
  37. Amichai B, Grunwald MH: Palmar telangiectasias and lung carcinoma: a possible association? J Eur Acad Dermatol Venereol 2002;16:185-186.
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