Erythematous macules in a 14-year-old girl

Abstract

Conflict of interest: none declared. A 14‐year‐old girl had a 1‐year history of multiple erythematous macules on her chest, back and legs. The lesions had initially appeared on her left leg and had progressively spread to the back and chest. She had no family or personal history of recurrent haemorrhages or telangiectases, and she was otherwise healthy and was not taking any medication. Skin examination revealed asymptomatic, multiple, round, small (about 15 mm in diameter), light red macules distributed on the chest, back and legs (Fig. 1). The lesions were identified as telangiectases only by loupe visualization and blanched under diascopy. Dermatoscopy showed a symmetrical lesion with multiple small arborizing vessels. There was no mucosal involvement. ... A biopsy specimen revealed dilated vessels without thrombi in the upper and mid dermis (Fig. 2). ... What is your diagnosis? Generalized essential telangiectasia (GET). GET is a distinct subset of idiopathic telangiectases characterized by widespread cutaneous distribution, progression or permanence of the lesions, accentuation by stasis (especially on the legs), and absence of coexisting epidermal or dermal changes such as atrophy, purpura, depigmentation and follicular involvement.1 The clinical appearance is characterized by a diffusely mottled pattern of delicate webs of dilated cutaneous vessels forming a syncytial arrangement with strikingly ecstatic vessels. Other descriptions of GET include plaque‐like, macular, retiform, sheet‐like, net‐like, mottled, nonpalpable, grouped or annular telangiectases. The lesions persist indefinitely through many years without an effect on the patient’s general health. Extracutaneous involvement of the oral mucosa and conjunctivae has also been documented. Standard laboratory tests give normal results.1–4