Enfoque diagnóstico del paciente con rubor facial transitorio en atención primaria
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dic 18, 2018
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Resumen
El rubor facial transitorio se define como una sensación de calor, acompañada de enrojecimiento de la piel, causada por una respuesta vasomotora con el resultante incremento en el flujo sanguíneo regional, debido a la acción directa de diferentes mediadores liberados por los nervios. Los cuadros pueden ser episódicos o constantes y se relacionan con respuestas fisiológicas y con patologías de origen benigno y maligno. El objetivo de la revisión es realizar un abordaje racional de esta condición en el escenario de atención primaria, con el fin de llegar a un diagnóstico precoz y completo, abordando los principales diagnósticos diferenciales asociados con esta condición.
Keywords
flushing; blushing; hot flashes; signs and symptoms; diagnosis, differential; primary preventionrubor; sofocos; manifestaciones clínicas; diagnóstico diferencial; prevención primaria
References
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2. Kaupp-Roberts S, Srirajaskanthan R, Ramage JK. Symptoms and quality of life in gastroenteropancreatic neuroendocrine tumors. Cit EMJ Oncol. 2015;3(1):34-40.
3. Salleras RM, Lamas Doménech N. Tratamiento del rubor facial (flushing). Piel. 2014;29(9):587-91.
4. Izikson L, English JC, Zirwas MJ. The flushing patient: Differential diagnosis, workup, and treatment. J Am Acad Dermatol. 2006;55(2):193-208.
5. Nasr C. Flushing. En: Current clinical medicine. 2nd ed. Cleveland: Elsevier; 2010. p. 369-75.
6. Luft FC. Asian flushing presents opportunities for disease prevention. J Mol Med. 2016;94(11):1195-7. doi: http://dx.doi.org/10.1007/s00109-016-1470-8.
7. Yale SH, Vasudeva S, Mazza JJ, Rolak L, Arrowood J, Stichert S, et al. Disorders of flushing. Compr Ther. 2005;31(1):59-71.
8. Scholing A, Emmelkamp PM. Cognitive and behavioural treatments of fear of blushing, sweating or trembling. Behav Res Ther. 1993;31:155-70.
9. Nicolaou M, Paes T, Wakelin S. Blushing: An embarrassing condition, but treatable. Lancet. 2006;367(9519):1297-9.
10. Drott C. Results of endoscopic thoracic sympathectomy (ETS) on hyperhidrosis, facial blushing, angina pectoris, vascular disorders and pain syndromes of the hand and arm. Clin Auton Res. 2003;13:1-1.
11. Tüzün Y, Wolf R, Kutlubay Z, Karakuş Ö, Engin B. Rosacea and rhinophyma. Clin Dermatol. 2014;32(1):35-46.
12. Molina AL, Londoño Á, Escobar SM, Benítez M. Guías clínicas para el tratamiento de la rosácea. Rev Asoc Colomb Dermatol. 2012 oct;20(4):339-64.
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14. Torrens MB. Rosácea y rinofima. AMF. 2013;9(7):397-401.
15. Schaller M, Schöfer H, Homey B, Hofmann M., Gieler U, Lehmann P, et al. Rosacea management: Update on general measures and topical treatment options. J Dtsch Dermatol Ges. 2016;14:17-27.
16. Troielli P, González FM, Ríos JM, Vásquez OT., Pabón JG, Ibarra M, et al. Actualización y recomendaciones para el diagnóstico y tratamiento de la rosácea en Latinoamérica. Med Cutan Iber Lat Am. 2016;44(supl 1):S7-26.
17. Takahashi TA, Johnson KM. Menopause. Med Clin North Am. 2015;99(3):521-34.
18. Freeman EW. Hot flushes and the menopause: How long should they be expected to last? Maturitas. 2014;78(3):153-4.
19. Ikizoglu G. Red face revisited: Flushing. Clin Dermatol. 2014;32(6):800-8.
20. Goodman NF, Cobin RH, Ginzburg SB, Katz IA, Woode DE. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Diagnosis and Treatment of Menopause. Endocrine Practice. 2011;17:1-25.
21. Hauk L. Acog releases clinical guidelines on management of menopausal symptoms. Am Fam Physician. 2014;90(5):338-40.
22. Sassarini J, Lumsden MA. Vascular function and cardiovascular risk factors in women with severe flushing. Maturitas. 2015;80(4):379-83.
23. Tuomikoski P, Savolainen-Peltonen H. Vasomotor symptoms and metabolic syndrome. Maturitas. 2017;97:61-5.
24. Hernandez L, Papalia S, Pujalte GA. Anaphylaxis. Prim Care Clin off Pract. 2016;43(3):477-85.
25. Adams KE, Rans TS. Adverse reactions to alcohol and alcoholic beverages. Ann Allergy Asthma Immunol. 2013;111(6):439-45.
26. Callejas MA. Blushing: pasado, presente y futuro. Arch Bronconeumol. 2009;45:65-7.
27. Huguet I, Grossman A. Flushing: current concepts. Eur J Endocrinol. 2017;177(5):R219-29.
28. Jayasena CN, Dhillo WS. Carcinoid syndrome and neuroendocrine tumours. Medicine. 2013;41;10:566-9.
29. Hannah SF, Stratakis Ca, Koch Ca. Flushing in (neuro) endocrinology. Rev Endocr Metab Disord. 2016;17(3):373-80.
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31. Herber GM, Mishra GD. Early severe vasomotor menopausal symptoms are associated with diabetes. Menopause. 2014;21(8):855-60.
32. Wells SA, Asa SL, Dralle H, et al. Revised American Thyroid Association Guidelines for the Management of Medullary Thyroid Carcinoma: The American Thyroid Association Guidelines Task Force on Medullary Thyroid Carcinoma. Thyroid. 2015;25(6):567-610. doi: https://doi.org/10.1089/thy.2014.0335.
33. Paschou SΑ, Vryonidou A, Goulis DG. Thyroid nodules: Α guide to assessment, treatment and follow-up. Maturitas. 2017;96:1-9.
34. Fazio SB. Approach to flushing in adults [internet]. 2016. Disponible en: http://www.uptodate.com/contents/approach-to-flushing-in-adults.
35. Quiroga Matamoros W, Fernández F, Citarella Otero D, Rangel J, Estrada Guerrero A, Patiño ID. Guía de manejo del carcinoma de células renales. Urol Colomb. 2016;25:169-89.
36. Ljungberg B, Damian HC, Marcus KA, Axel MS, Peter Mulders FA, Patard J, et al. Guía del carcinoma de células renales. Actas Urol Esp. 2009;33(3):270-79.
37. Hutson TE. Targeted therapies for the treatment of metastatic renal cell carcinoma: Clinical evidence. Oncologist. 2011;16(Suppl 2):14-22.
38. Sadeghian A, Rouhana H, Oswald-Stumpf B, Boh E. Continuing medical education: Etiologies and management of cutaneous flushing. Malignant causes. J Am Acad Dermatol 2017;77:405-14.
39. Akin C, Valent P. Diagnostic criteria and classification of mastocytosis in 2014. Immunol Allergy Clin North Am. 2014;34(2):207-18.
40. Wolin EM. The expanding role of somatostatin analogs in the management of neuroendocrine tumors. Gastrointest Cancer Res. 2012;5(5):161-8.
41. Jones MR, Vertovse KS, Jorgensen JL, Manshoveri T, Luther R, Jones DM, et al. Utility of the World Health Organization classification criteria for the diagnosis of systemic mastocytosis in bone marrow. Mod Pathol. 2009;22(1):50-7.
42. Izikson L, English JC, Zirwas MJ. The flushing patient: Differential diagnosis, workup, and treatment. J Am Acad Dermatol. 2006;55(2):193-208.
43. Frisk J. Review: Managing hot flushes in men after prostate cancer—A systematic review. Maturitas. 2010;65:15-22.
44. Ahmadi H, Daneshmand S. Androgen deprivation therapy: Evidence-based management of side effects. BJU Int. 2013;111(4):543-8. doi: https://doi.org/10.1111/j.1464-410X.2012.11774.x.
45. Frisk JW, Hammar ML, Ingvar M, et al. How long do the effects of acupuncture on hot flashes persist in cancer patients? Suppoert Care Cancer. 2014;22(5):1409-15.
46. Girish G, D’souza RE, D’souza P, Lewis MG, Baker DM. Role of surgical thoracic sympathetic interruption in treatment of facial blushing: a systematic review. Postgrad Med. 2017;129(2):267-75. doi: https://doi.org/10.1080/00325481.2017.1283207.
47. Kristian S, Christer D. Facial blushing: Patient selection and long-term results. Thorac Surg Clin. 2016;26(4):459-63. doi: https://doi.org/10.1016/j.thorsurg.2016.06.011
48. Park KY, Hyun MY, Jeong SY, Kim BJ, Kim MN., Hong CK. Botulinum toxin for the treatment of refractory erythema and flushing of rosacea. Dermatology. 2015;230(4):299-301.
2. Kaupp-Roberts S, Srirajaskanthan R, Ramage JK. Symptoms and quality of life in gastroenteropancreatic neuroendocrine tumors. Cit EMJ Oncol. 2015;3(1):34-40.
3. Salleras RM, Lamas Doménech N. Tratamiento del rubor facial (flushing). Piel. 2014;29(9):587-91.
4. Izikson L, English JC, Zirwas MJ. The flushing patient: Differential diagnosis, workup, and treatment. J Am Acad Dermatol. 2006;55(2):193-208.
5. Nasr C. Flushing. En: Current clinical medicine. 2nd ed. Cleveland: Elsevier; 2010. p. 369-75.
6. Luft FC. Asian flushing presents opportunities for disease prevention. J Mol Med. 2016;94(11):1195-7. doi: http://dx.doi.org/10.1007/s00109-016-1470-8.
7. Yale SH, Vasudeva S, Mazza JJ, Rolak L, Arrowood J, Stichert S, et al. Disorders of flushing. Compr Ther. 2005;31(1):59-71.
8. Scholing A, Emmelkamp PM. Cognitive and behavioural treatments of fear of blushing, sweating or trembling. Behav Res Ther. 1993;31:155-70.
9. Nicolaou M, Paes T, Wakelin S. Blushing: An embarrassing condition, but treatable. Lancet. 2006;367(9519):1297-9.
10. Drott C. Results of endoscopic thoracic sympathectomy (ETS) on hyperhidrosis, facial blushing, angina pectoris, vascular disorders and pain syndromes of the hand and arm. Clin Auton Res. 2003;13:1-1.
11. Tüzün Y, Wolf R, Kutlubay Z, Karakuş Ö, Engin B. Rosacea and rhinophyma. Clin Dermatol. 2014;32(1):35-46.
12. Molina AL, Londoño Á, Escobar SM, Benítez M. Guías clínicas para el tratamiento de la rosácea. Rev Asoc Colomb Dermatol. 2012 oct;20(4):339-64.
13. Sadeghian A, Rouhana H, Oswald-Stumpf B, Boh E. Continuing medical education: Etiologies and management of cutaneous flushing. Nonmalignant causes. J Am Acad Dermatol 2017;77:391-402.
14. Torrens MB. Rosácea y rinofima. AMF. 2013;9(7):397-401.
15. Schaller M, Schöfer H, Homey B, Hofmann M., Gieler U, Lehmann P, et al. Rosacea management: Update on general measures and topical treatment options. J Dtsch Dermatol Ges. 2016;14:17-27.
16. Troielli P, González FM, Ríos JM, Vásquez OT., Pabón JG, Ibarra M, et al. Actualización y recomendaciones para el diagnóstico y tratamiento de la rosácea en Latinoamérica. Med Cutan Iber Lat Am. 2016;44(supl 1):S7-26.
17. Takahashi TA, Johnson KM. Menopause. Med Clin North Am. 2015;99(3):521-34.
18. Freeman EW. Hot flushes and the menopause: How long should they be expected to last? Maturitas. 2014;78(3):153-4.
19. Ikizoglu G. Red face revisited: Flushing. Clin Dermatol. 2014;32(6):800-8.
20. Goodman NF, Cobin RH, Ginzburg SB, Katz IA, Woode DE. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Diagnosis and Treatment of Menopause. Endocrine Practice. 2011;17:1-25.
21. Hauk L. Acog releases clinical guidelines on management of menopausal symptoms. Am Fam Physician. 2014;90(5):338-40.
22. Sassarini J, Lumsden MA. Vascular function and cardiovascular risk factors in women with severe flushing. Maturitas. 2015;80(4):379-83.
23. Tuomikoski P, Savolainen-Peltonen H. Vasomotor symptoms and metabolic syndrome. Maturitas. 2017;97:61-5.
24. Hernandez L, Papalia S, Pujalte GA. Anaphylaxis. Prim Care Clin off Pract. 2016;43(3):477-85.
25. Adams KE, Rans TS. Adverse reactions to alcohol and alcoholic beverages. Ann Allergy Asthma Immunol. 2013;111(6):439-45.
26. Callejas MA. Blushing: pasado, presente y futuro. Arch Bronconeumol. 2009;45:65-7.
27. Huguet I, Grossman A. Flushing: current concepts. Eur J Endocrinol. 2017;177(5):R219-29.
28. Jayasena CN, Dhillo WS. Carcinoid syndrome and neuroendocrine tumours. Medicine. 2013;41;10:566-9.
29. Hannah SF, Stratakis Ca, Koch Ca. Flushing in (neuro) endocrinology. Rev Endocr Metab Disord. 2016;17(3):373-80.
30. Franco UC, Pardo BF, Laborda HR, Pérez LC. Usefulness of ultrasonography is the evaluation of thyroid nodules. Radiología. 2016;58(5):380-8.
31. Herber GM, Mishra GD. Early severe vasomotor menopausal symptoms are associated with diabetes. Menopause. 2014;21(8):855-60.
32. Wells SA, Asa SL, Dralle H, et al. Revised American Thyroid Association Guidelines for the Management of Medullary Thyroid Carcinoma: The American Thyroid Association Guidelines Task Force on Medullary Thyroid Carcinoma. Thyroid. 2015;25(6):567-610. doi: https://doi.org/10.1089/thy.2014.0335.
33. Paschou SΑ, Vryonidou A, Goulis DG. Thyroid nodules: Α guide to assessment, treatment and follow-up. Maturitas. 2017;96:1-9.
34. Fazio SB. Approach to flushing in adults [internet]. 2016. Disponible en: http://www.uptodate.com/contents/approach-to-flushing-in-adults.
35. Quiroga Matamoros W, Fernández F, Citarella Otero D, Rangel J, Estrada Guerrero A, Patiño ID. Guía de manejo del carcinoma de células renales. Urol Colomb. 2016;25:169-89.
36. Ljungberg B, Damian HC, Marcus KA, Axel MS, Peter Mulders FA, Patard J, et al. Guía del carcinoma de células renales. Actas Urol Esp. 2009;33(3):270-79.
37. Hutson TE. Targeted therapies for the treatment of metastatic renal cell carcinoma: Clinical evidence. Oncologist. 2011;16(Suppl 2):14-22.
38. Sadeghian A, Rouhana H, Oswald-Stumpf B, Boh E. Continuing medical education: Etiologies and management of cutaneous flushing. Malignant causes. J Am Acad Dermatol 2017;77:405-14.
39. Akin C, Valent P. Diagnostic criteria and classification of mastocytosis in 2014. Immunol Allergy Clin North Am. 2014;34(2):207-18.
40. Wolin EM. The expanding role of somatostatin analogs in the management of neuroendocrine tumors. Gastrointest Cancer Res. 2012;5(5):161-8.
41. Jones MR, Vertovse KS, Jorgensen JL, Manshoveri T, Luther R, Jones DM, et al. Utility of the World Health Organization classification criteria for the diagnosis of systemic mastocytosis in bone marrow. Mod Pathol. 2009;22(1):50-7.
42. Izikson L, English JC, Zirwas MJ. The flushing patient: Differential diagnosis, workup, and treatment. J Am Acad Dermatol. 2006;55(2):193-208.
43. Frisk J. Review: Managing hot flushes in men after prostate cancer—A systematic review. Maturitas. 2010;65:15-22.
44. Ahmadi H, Daneshmand S. Androgen deprivation therapy: Evidence-based management of side effects. BJU Int. 2013;111(4):543-8. doi: https://doi.org/10.1111/j.1464-410X.2012.11774.x.
45. Frisk JW, Hammar ML, Ingvar M, et al. How long do the effects of acupuncture on hot flashes persist in cancer patients? Suppoert Care Cancer. 2014;22(5):1409-15.
46. Girish G, D’souza RE, D’souza P, Lewis MG, Baker DM. Role of surgical thoracic sympathetic interruption in treatment of facial blushing: a systematic review. Postgrad Med. 2017;129(2):267-75. doi: https://doi.org/10.1080/00325481.2017.1283207.
47. Kristian S, Christer D. Facial blushing: Patient selection and long-term results. Thorac Surg Clin. 2016;26(4):459-63. doi: https://doi.org/10.1016/j.thorsurg.2016.06.011
48. Park KY, Hyun MY, Jeong SY, Kim BJ, Kim MN., Hong CK. Botulinum toxin for the treatment of refractory erythema and flushing of rosacea. Dermatology. 2015;230(4):299-301.
Cómo citar
Vivas Prieto, J. M., Caballero Vera, S. V., & Echeverry Ramírez, M. (2018). Enfoque diagnóstico del paciente con rubor facial transitorio en atención primaria. Universitas Medica, 60(1). https://doi.org/10.11144/Javeriana.umed60-1.edpr
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