progressive ascending telangiectasia (PAT) is a rare disease characterized by the development of telangiectatic vessels, initially limited to the feet and ankles, and later spreading up to the legs and onto the trunk and arms
the disorder is characterized by the development of telangiectasias which appear initially on the distal lower extremities but slowly and progressively spread to involve the trunk, arms, and face
women are the most commonly affected, with an average age of onset in the fourth decade of life
diagnosis is clinical, once other primary and secondary causes of telangiectasias have been excluded
typical evolution makes it possible to distinguish it from the general group of essential telangiectasia
systemic treatment with tetracyclines, ketoconazole, and acyclovir has been reported to have been effective in some cases (1,2), and a focal clotting process within the capillaries of the skin, induced by candidal or bacterial endotoxin antigens has been advocated as a pathogenic mechanism (3)
only isolated cases treated with each of the above-mentioned drugs have been published, so these cannot be considered as generally accepted treatment measures
other therapeutic options include sclerosing therapies, e.g. polydocanol, and pulsed dye laser (585 nm) (3,4)
Reference:
1. Shelley WB, Fierer JA. Focal intra-vascular coagulation in progressive ascending telangiectasia: ultrastructural studies of ketoconazole-induced involution of vessels. J Am Acad Dermatol 1984; 10 (5): 876-877
2. Shelley WB, Shelley ED. Essential progressive telangiectasia in an autoimmune setting: successful treatment with acyclovir. J Am Acad Dermatol 1989;21(5): 1094-1096.
3. Buscaglia DA, Conte ET. Successful treatment of generalised essential telangiectasia with the 585-nm flash lamp-pumped pulsed dye laser. Cutis 2001;67(2): 107-108.
4. Seiter S et al. An oculocutaneous presentation of essential progressive telangiectasia.British Journal of Dermatology 1999; 140 (5): 969-971.
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