Erythrophobia R23.21

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Affect erythema; Affective hyperemia; Erythema e irritatione; Erythema e pudore; Erythema iracundiae; erythema pudicitiae; Pubic blush

Definition
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Emotionally triggered, intellectually uncontrollable, flush-like (passagere), diffuse redness (possibly also swelling) of the face and the lateral parts of the neck, accompanied by a non-itching, irregular, macular exanthema. Often a vicious circle develops from self-monitoring and worry about a sudden uncontrollable redness. Situations that lead to blushing are often consciously avoided, the affected persons increasingly withdraw. Thus, it is not the actual blushing that is the problem, but the fear of it (see below somatoform disorders).

Manifestation
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Especially in psychovegetatively unstable adolescents. Predominantly occurring in female sexual intercourse.

Localization
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Décolleté, lateral neck and cheek areas, also other sections of the upper torso (e.g. neck).

Clinical features
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Acute, bizarre, 2.0-10.0 cm large, sharply defined, anaemic, bright red spots (erythema), which suddenly appear in an emotional stress situation. The erythema starts uncontrollably and disappears again suddenly after the situation-related excitement phase has subsided. Usually combined with palmar or axillary hyperhidrosis or acrocyanosis.

Diagnosis
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The clinic with the sudden, situational erythema formation is proving.

Differential diagnosis
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Flush of other genesis (e.g. nutritive, medicinal); erythema perstans faciei; systemic lupus erythematosus.

Therapy
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  • Try beta blockers.
  • If drug therapy is not successful and in case of extreme annoyance of a personality with the risk of social isolation: endoscopic transthoracic sympathectomy (ETS): Effective and permanently effective, minimally invasive intervention via endoscopic access. 2 major side effects have been described: postoperative pneumothorax < 2%; passant compensatory sweating < 20%. Caution! Transthoracic sympathectomy can only be performed in specialized centers.

Progression/forecast
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The reactivity decreases significantly until the middle of the day!

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020