Dermatology disorders

Can you identify this asymptomatic rash?

David L. Kaplan, Md––Series Editor: Dr Kaplan is clinical assistant professor of dermatology at the University of Missouri Kansas City School of Medicine and at the University of Kansas School of Medicine. He practices adult and pediatric dermatology in Overland Park, Kan.



A 40-year-old woman has had an asymptomatic red rash on her feet and ankles for about 3 months. She has chronic sinusitis but is not taking any medication. She has not changed soap or bathing habits and has no history of contact dermatitis or leg swelling.


Which of the following do you suspect?

A. Stasis dermatitis.

B. Myxedema.

C. Essential telangiectasia.

D. Benign pigmented purpura.

E. Leukocytoclastic vasculitis.


ANSWER—Essential telangiectasia

This is the classic presentation of generalized essential telangiectasia, C. The typical patient is a woman in her 30s or 40s; the rash generally erupts on the lower extremities. The cause is unknown; however, the disorder has been associated with sinus infection and has resolved following oral antibiotic therapy.

Stasis dermatitis usually involves pedal edema. Myxedema generally presents with nonpitting edema. Benign pigmented purpura and vasculitis are characterized by petechiae, not telangiectases.

An antibiotic was prescribed for this patient, but she was lost to follow-up.