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Flushing

MedGen UID:
5234
Concept ID:
C0016382
Sign or Symptom
Synonym: Flushings
SNOMED CT: Flushing (20255002); Flush (20255002); Flushing (238810007); Flushes (271811009); Face goes red (271811009)
 
HPO: HP:0031284

Definition

Recurrent episodes of redness of the skin together with a sensation of warmth or burning of the affected areas of skin. [from HPO]

Conditions with this feature

Chinese restaurant syndrome
MedGen UID:
891
Concept ID:
C0008127
Disease or Syndrome
MULTIPLE ENDOCRINE NEOPLASIA, TYPE IIB
MedGen UID:
9959
Concept ID:
C0025269
Neoplastic Process
Multiple endocrine neoplasia type 2 (MEN2) includes the following phenotypes: MEN2A, FMTC (familial medullary thyroid carcinoma, which may be a variant of MEN2A), and MEN2B. All three phenotypes involve high risk for development of medullary carcinoma of the thyroid (MTC); MEN2A and MEN2B involve an increased risk for pheochromocytoma; MEN2A involves an increased risk for parathyroid adenoma or hyperplasia. Additional features in MEN2B include mucosal neuromas of the lips and tongue, distinctive facies with enlarged lips, ganglioneuromatosis of the gastrointestinal tract, and a marfanoid habitus. MTC typically occurs in early childhood in MEN2B, early adulthood in MEN2A, and middle age in FMTC.
Vibratory urticaria
MedGen UID:
510413
Concept ID:
C0157743
Disease or Syndrome
Autosomal dominant vibratory urticaria is characterized by localized hives and systemic manifestations in response to dermal vibration, with coincident degranulation of mast cells and increased histamine levels in serum (Boyden et al., 2016).
Brunner syndrome
MedGen UID:
208683
Concept ID:
C0796275
Disease or Syndrome
Brunner syndrome is a recessive X-linked disorder characterized by impulsive aggressiveness and mild mental retardation associated with MAOA deficiency (Brunner et al., 1993).
Paroxysmal extreme pain disorder
MedGen UID:
331565
Concept ID:
C1833661
Disease or Syndrome
SCN9A neuropathic pain syndromes (SCN9A-NPS) comprise SCN9A erythromelalgia (EM), SCN9A paroxysmal extreme pain disorder (PEPD), and SCN9A small fiber neuropathy (SFN). SCN9A-EM is characterized by recurrent episodes of bilateral intense, burning pain, and redness, warmth, and occasionally swelling. While the feet are more commonly affected than the hands, in severely affected individuals the legs, arms, face, and/or ears may be involved. SCN9A-PEPD is characterized by neonatal or infantile onset of autonomic manifestations that can include skin flushing, harlequin (patchy or asymmetric) color change, tonic non-epileptic attacks (stiffening), and syncope with bradycardia. Later manifestations are episodes of excruciating deep burning rectal, ocular, or submandibular pain accompanied by flushing (erythematous skin changes). SCN9A-SFN is characterized by adult-onset neuropathic pain in a stocking and glove distribution, often with a burning quality; autonomic manifestations such as dry eyes, mouth, orthostatic dizziness, palpitations, bowel or bladder disturbances; and preservation of large nerve fiber functions (normal strength, tendon reflexes, and vibration sense).
Maturity-onset diabetes of the young type 1
MedGen UID:
377589
Concept ID:
C1852093
Disease or Syndrome
Maturity-onset diabetes of the young (MODY) is a group of several conditions characterized by abnormally high levels of blood glucose, also called blood sugar. These forms of diabetes typically begin before age 30, although they can occur later in life. In MODY, elevated blood glucose arises from reduced production of insulin, which is a hormone produced in the pancreas that helps regulate blood glucose levels. Specifically, insulin controls how much glucose (a type of sugar) is passed from the blood into cells, where it is used as an energy source.\n\nRCAD is associated with a combination of diabetes and kidney or urinary tract abnormalities (unrelated to the elevated blood glucose), most commonly fluid-filled sacs (cysts) in the kidneys. However, the signs and symptoms are variable, even within families, and not everyone with RCAD has both features. Affected individuals may have other features unrelated to diabetes, such as abnormalities of the pancreas or liver or a form of arthritis called gout.\n\nGCK-MODY is a very mild type of the condition. People with this type have slightly elevated blood glucose levels, particularly in the morning before eating (fasting blood glucose). However, affected individuals often have no symptoms related to the disorder, and diabetes-related complications are extremely rare.\n\nThe different types of MODY are distinguished by their genetic causes. The most common types are HNF1A-MODY (also known as MODY3), accounting for 50 to 70 percent of cases, and GCK-MODY (MODY2), accounting for 30 to 50 percent of cases. Less frequent types include HNF4A-MODY (MODY1) and renal cysts and diabetes (RCAD) syndrome (also known as HNF1B-MODY or MODY5), which each account for 5 to 10 percent of cases. At least ten other types have been identified, and these are very rare.\n\nHNF1A-MODY and HNF4A-MODY have similar signs and symptoms that develop slowly over time. Early signs and symptoms in these types are caused by high blood glucose and may include frequent urination (polyuria), excessive thirst (polydipsia), fatigue, blurred vision, weight loss, and recurrent skin infections. Over time uncontrolled high blood glucose can damage small blood vessels in the eyes and kidneys. Damage to the light-sensitive tissue at the back of the eye (the retina) causes a condition known as diabetic retinopathy that can lead to vision loss and eventual blindness. Kidney damage (diabetic nephropathy) can lead to kidney failure and end-stage renal disease (ESRD). While these two types of MODY are very similar, certain features are particular to each type. For example, babies with HNF4A-MODY tend to weigh more than average or have abnormally low blood glucose at birth, even though other signs of the condition do not occur until childhood or young adulthood. People with HNF1A-MODY have a higher-than-average risk of developing noncancerous (benign) liver tumors known as hepatocellular adenomas.
Hypertrophic osteoarthropathy, primary, autosomal recessive, 1
MedGen UID:
1641972
Concept ID:
C4551679
Disease or Syndrome
Autosomal recessive primary hypertrophic osteoarthropathy-1 (PHOAR1) is a rare familial disorder characterized by digital clubbing, osteoarthropathy, and acroosteolysis, with variable features of pachydermia, delayed closure of the fontanels, and congenital heart disease (summary by Uppal et al., 2008; Radhakrishnan et al., 2020). Secondary hypertrophic osteoarthropathy, or pulmonary hypertrophic osteoarthropathy, is a different disorder characterized by digital clubbing secondary to acquired diseases, most commonly intrathoracic neoplasm (Uppal et al., 2008). Touraine et al. (1935) recognized pachydermoperiostosis as a familial disorder with 3 clinical presentations or forms: a complete form characterized by periostosis and pachydermia; an incomplete form with bone changes but without pachydermia; and a 'forme fruste' with pachydermia and minimal skeletal changes. Genetic Heterogeneity Autosomal recessive primary hypertrophic osteoarthropathy-2-enteropathy syndrome (PHOAR2E; 614441) is caused by mutation in the SLCO2A1 gene (601460) on chromosome 3q22. Families with an autosomal dominant form of primary hypertrophic osteoarthropathy have also been reported (PHOAD; 167100).

Professional guidelines

PubMed

Sharma A, Kroumpouzos G, Kassir M, Galadari H, Goren A, Grabbe S, Goldust M
J Cosmet Dermatol 2022 May;21(5):1895-1904. Epub 2022 Feb 14 doi: 10.1111/jocd.14816. PMID: 35104917
Robbins MS
JAMA 2021 May 11;325(18):1874-1885. doi: 10.1001/jama.2021.1640. PMID: 33974014
van Zuuren EJ, Arents BWM, van der Linden MMD, Vermeulen S, Fedorowicz Z, Tan J
Am J Clin Dermatol 2021 Jul;22(4):457-465. Epub 2021 Mar 23 doi: 10.1007/s40257-021-00595-7. PMID: 33759078Free PMC Article

Recent clinical studies

Etiology

Shermon S, Van Acker G, Suric V, Kim C, Abd-Elsayed A, Mata N
Curr Pain Headache Rep 2023 Jun;27(6):143-148. Epub 2023 Apr 28 doi: 10.1007/s11916-023-01117-2. PMID: 37115487
Lainas G, Lainas T, Kolibianakis E
Curr Opin Obstet Gynecol 2023 Jun 1;35(3):238-245. Epub 2023 Mar 17 doi: 10.1097/GCO.0000000000000870. PMID: 36943690
Wessel JA, Hunt S, van Wely M, Mol F, Wang R
Fertil Steril 2023 Sep;120(3 Pt 1):483-493. Epub 2023 Jan 13 doi: 10.1016/j.fertnstert.2023.01.011. PMID: 36642301
Jeon S, Kang H, Cho I, Cho SI
Sci Rep 2022 Jul 22;12(1):12569. doi: 10.1038/s41598-022-16276-2. PMID: 35869160Free PMC Article
Alexis AF, Callender VD, Baldwin HE, Desai SR, Rendon MI, Taylor SC
J Am Acad Dermatol 2019 Jun;80(6):1722-1729.e7. Epub 2018 Sep 19 doi: 10.1016/j.jaad.2018.08.049. PMID: 30240779

Diagnosis

Sharma R, Khan H
Neurol Sci 2023 Aug;44(8):2989-2990. Epub 2023 May 18 doi: 10.1007/s10072-023-06849-y. PMID: 37199876
Thiboutot D, Anderson R, Cook-Bolden F, Draelos Z, Gallo RL, Granstein RD, Kang S, Macsai M, Gold LS, Tan J
J Am Acad Dermatol 2020 Jun;82(6):1501-1510. Epub 2020 Feb 7 doi: 10.1016/j.jaad.2020.01.077. PMID: 32035944
Alexis AF, Callender VD, Baldwin HE, Desai SR, Rendon MI, Taylor SC
J Am Acad Dermatol 2019 Jun;80(6):1722-1729.e7. Epub 2018 Sep 19 doi: 10.1016/j.jaad.2018.08.049. PMID: 30240779
Lal V, Mamoojee YH, Quinton R
Post Reprod Health 2017 Dec;23(4):177-182. Epub 2017 Jun 26 doi: 10.1177/2053369117715371. PMID: 28649907
Hannah-Shmouni F, Stratakis CA, Koch CA
Rev Endocr Metab Disord 2016 Sep;17(3):373-380. doi: 10.1007/s11154-016-9394-8. PMID: 27873108Free PMC Article

Therapy

Wang B, Huang Y, Tang Y, Zhao Z, Shi W, Jian D, Liu F, Gao Q, Wang P, Yang J, Li L, Xie H, Li J
J Am Acad Dermatol 2023 Jun;88(6):1300-1307. Epub 2023 Feb 15 doi: 10.1016/j.jaad.2023.01.044. PMID: 36806645
Gong B, Ma M, Xie W, Yang X, Huang Y, Sun T, Luo Y, Huang J
Int Urol Nephrol 2017 Oct;49(10):1731-1740. Epub 2017 Jul 24 doi: 10.1007/s11255-017-1644-5. PMID: 28741090Free PMC Article
van Zuuren EJ, Fedorowicz Z, Carter B, van der Linden MM, Charland L
Cochrane Database Syst Rev 2015 Apr 28;2015(4):CD003262. doi: 10.1002/14651858.CD003262.pub5. PMID: 25919144Free PMC Article
Duley L, Gülmezoglu AM, Henderson-Smart DJ, Chou D
Cochrane Database Syst Rev 2010 Nov 10;2010(11):CD000025. doi: 10.1002/14651858.CD000025.pub2. PMID: 21069663Free PMC Article
Malhotra HS, Plosker GL
Drugs 2001;61(7):989-96; discussion 997-8. doi: 10.2165/00003495-200161070-00007. PMID: 11434453

Prognosis

de Bijl-Marcus K, Brouwer AJ, De Vries LS, Groenendaal F, Wezel-Meijler GV
Arch Dis Child Fetal Neonatal Ed 2020 Jul;105(4):419-424. Epub 2019 Nov 15 doi: 10.1136/archdischild-2018-316692. PMID: 31732682
Guenezan J, Drugeon B, O'Neill R, Caillaud D, Sénamaud C, Pouzet C, Seguin S, Frasca D, Mimoz O
BMJ Open 2019 Apr 2;9(4):e028549. doi: 10.1136/bmjopen-2018-028549. PMID: 30944142Free PMC Article
Guo Y, Tian X, Wang X, Xiao Z
Front Immunol 2018;9:1299. Epub 2018 Jun 8 doi: 10.3389/fimmu.2018.01299. PMID: 29951056Free PMC Article
Fishbane S, Spinowitz B
Am J Kidney Dis 2018 Mar;71(3):423-435. Epub 2018 Jan 11 doi: 10.1053/j.ajkd.2017.09.026. PMID: 29336855
Srinivasan PS, Brandler MD, D'Souza A
Clin Perinatol 2008 Mar;35(1):251-72, x. doi: 10.1016/j.clp.2007.11.009. PMID: 18280885

Clinical prediction guides

Ribeiro GDSR, Campos JF, Silva RCD
Rev Bras Enferm 2022;75(5):e20210418. Epub 2022 Feb 25 doi: 10.1590/0034-7167-2021-0418. PMID: 35584422
Welie NV, Ludwin A, Martins WP, Mijatovic V, Dreyer K
Semin Reprod Med 2020 Jan;38(1):74-86. Epub 2020 Dec 18 doi: 10.1055/s-0040-1721720. PMID: 33339062
Gray S
Post Reprod Health 2018 Mar;24(1):50-52. doi: 10.1177/2053369118761322. PMID: 29554855
Neumann K, Griesinger G
Reprod Biomed Online 2018 Apr;36(4):408-415. Epub 2017 Dec 29 doi: 10.1016/j.rbmo.2017.12.014. PMID: 29336996
Drolet B, Paller AS
Pediatr Dermatol 1992 Mar;9(1):22-6. doi: 10.1111/j.1525-1470.1992.tb00320.x. PMID: 1533454

Recent systematic reviews

Bae JY, Sung HK, Kwon NY, Go HY, Kim TJ, Shin SM, Lee S
Medicina (Kaunas) 2021 Dec 28;58(1) doi: 10.3390/medicina58010044. PMID: 35056352Free PMC Article
Martina E, Diotallevi F, Radi G, Campanati A, Offidani A
Toxins (Basel) 2021 Feb 5;13(2) doi: 10.3390/toxins13020120. PMID: 33562846Free PMC Article
Gong B, Ma M, Xie W, Yang X, Huang Y, Sun T, Luo Y, Huang J
Int Urol Nephrol 2017 Oct;49(10):1731-1740. Epub 2017 Jul 24 doi: 10.1007/s11255-017-1644-5. PMID: 28741090Free PMC Article
van Zuuren EJ, Fedorowicz Z, Carter B, van der Linden MM, Charland L
Cochrane Database Syst Rev 2015 Apr 28;2015(4):CD003262. doi: 10.1002/14651858.CD003262.pub5. PMID: 25919144Free PMC Article
Duley L, Gülmezoglu AM, Henderson-Smart DJ, Chou D
Cochrane Database Syst Rev 2010 Nov 10;2010(11):CD000025. doi: 10.1002/14651858.CD000025.pub2. PMID: 21069663Free PMC Article

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