Abstract Flushing is a transient reddening of the face and frequently other areas, including the neck, the upper chest, and epigastric area.1 Despite the limited cutaneous distribution, many of the agents that provoke flushing are systemic and lead to increases in skin blood flow at both malar and forearm sites.2 Both a greater capacitance in the facial cutaneous vasculature and a cluster of optical phenomena, such as wider vascular diameters, vessels nearer the surface, and less tissue fluid obscuring the vessels, account for the limited distribution of flushing.2 Since flushing is a phenomenon of transient, usually systemic, vasodilation, it is useful to understand the dual control of vascular smooth muscle by nerves and circulating agents.3 Thus, flushing mechanisms may be broadly classified into those due to direct action of the circulating agents and those mediated by nerves. Autonomic nerves also control the eccrine sweat glands so that References 1. Wilkin JK. Flushing reactions . In: Rook AJ, Mailbach HI, eds. Recent Advances in Dermatology . New York, NY: Churchill-Livingstone Inc; 1983;6:157-187. 2. Wilkin JK. Why is flushing limited to a mostly facial cutaneous distribution? J Am Acad Dermatol. 1988;19:309-313.Crossref 3. Burnstock G, Iwayama T. Fine-structural identification of autonomic nerves and their relation to smooth muscle . Prog Brain Res. 1971;34:389-404. 4. Curran CF. Doxorubicin-associated facial flushing . Arch Dermatol. 1992;128:1408.Crossref 5. Kennedy BJ. Metabolic and toxic effects of mithramycin during tumor therapy . Am J Med. 1970;49:494-503.Crossref 6. Bronner AK, Hood AF. Cutaneous complications of chemotherapeutic agents . J Am Acad Dermatol. 1983;9:645-663.Crossref 7. Edwards L, Levine N, Weidner M, Piepkorn M, Smiles K. Effect of intralesional alpha 2-interferon on actinic keratoses . Arch Dermatol. 1986;122:779-782.Crossref 8. Joss RA, Galeazzi RL, Bischoff AK, Pirovino M, Ryssel HJ, Brunner KW. The antiemetic activity of high-dose alizapride and high-dose metoclopramide in patients receiving cancer chemotherapy: a prospective, randomized, double-blind trial . Clin Pharmacol Ther. 1986;39:619-624.Crossref 9. Salmon SE, Sartorelli AC. Cancer chemotherapy . In: Katzung BG, ed. Basic and Clinical Pharmacology . 4th ed. East Norwalk, Conn: Appleton & Lange; 1989;56:683-715 699. 10. Love RR, Cameron L, Connell BL, Leventhal H. Symptoms associated with tamoxifen treatment in postmenopausal women . Arch Intern Med. 1991;151:1842-1847.Crossref 11. Leuprolide for prostate cancer . Med Lett. 1985;27:71-72. Editorial. 12. Wilkin JK. Vasodilator rosacea . Arch Dermatol. 1980;116:598.Crossref 13. Red men should go: vancomycin and histamine release . Lancet . 1990;335:1006-1007. Editorial.Crossref 14. Hong Kong Tuberculosis Treatment Services, Brompton Hospital, British Medical Research Council Investigation. A controlled clinical trial of daily and intermittent regimens of rifampicin plus ethambutol in the retreatment of patients with pulmonary tuberculosis in Hong Kong . Tubercle . 1974;55:1-27. 15. Brewin TB. Alcohol intolerance in neoplastic disease . BMJ . 1966;2:437-441.Crossref 16. Bichel J. The alcohol-intolerance syndrome in Hodgkin's disease . Acta Med Scand. 1959;164:105-112.Crossref 17. Shehadi WH. Adverse reactions to intravascularly administered contrast media: a comprehensive study based on a prospective survey . Am J Radiol. 1975;124:145-152. 18. Wilkin JK. Climacteric flushing in a patient with carcinoid tumour . Br J Dermatol. 1985;112:357-361.Crossref 19. Young WF, Zinsmeister AR, Twomey CK, Kao PC, Jiang N-S, Carpenter PC. Ovine corticotropin releasing hormone stimulation test: normal value study . Mayo Clin Proc. 1990;65:943-948.Crossref 20. Seltzer JL, Goldberg ME, Larijani GE, et al. Prostacyclin mediation of vasodilation following mesenteric traction . Anesthesiology . 1988;68:514-518.Crossref 21. Seltzer JL, Ritter DE, Starsnic MA, Marr AT. The hemodynamic response to traction on the abdominal mesentery . Anesthesiololgy . 1985;63:96-99.Crossref 22. Kissane JM. Pathology of Infancy and Childhood . 2nd ed. St Louis, Mo: CV Mosby Co; 1975:581.
Archives of Dermatology – American Medical Association
Published: Oct 1, 1992
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