Đỏ mặt (Plethora/Facial plethora)

Mô tả: An excess of blood in a part or, by extension, a red florid complexion.37

Nguyên nhân: More common • Chronic alcoholism • Cushing’s disease • Parenchymal lung disease • Menopause Less common • Polycythaemia • Hypernephroma • SVC obstruction • Mitral stenosis • Carcinoid syndrome

Cơ chế: Plethora can be caused by an increased volume of blood flow to the face, any factor that may dilate the blood vessels in the area or blood vessels being closer to the skin’s surface. Cushing’s disease In Cushing’s disease excess cortisol causes degradation and atrophy of the epidermis and underlying connective tissue. This leads to apparent thinning of the skin and the appearance of facial plethora.2 Carcinoid syndrome Excess serotonin release seen in carcinoid syndrome causes the dilatation of skin vessels and the appearance of plethora. Mitral stenosis Mitral stenosis leads to increased pressure from the left side of the heart. This leads to increased venule and venous pressure, engorging small capillaries and causing plethora. Parenchymal lung disease Parenchymal lung disease may cause raised pulmonary artery pressure and, therefore, pressure back to the right side of the heart and into the venous system. This, in turn, can increase venous pressure, causing engorgement of blood vessels in the face.

Ý nghĩa lâm sàng: Seen in 70% of patients with Cushing’s syndrome,2 plethora has only limited specificity given its many possible aetiologies.