title: [Telangiectasia during amlodipine therapy].
abstract: BACKGROUND
  Calcium inhibitors are recommended as first-line treatment in hypertension. We report the development of telangiectasia on the trunk and upper limbs in a female patient on amlodipine (Amlor(®)) that subsided on treatment discontinuation.
  
  
  METHODS
  A 63-year-old woman consulted for numerous asymptomatic stellate telangiectasias on her upper trunk and shoulders, with sparing of the face. No Darier's sign was seen and clinical examination was otherwise normal. The patient had been treated with amlodipine (Amlor(®)) and a combination of bisoprolol and hydrochlorothiazide (Lodoz(®)) for 5years for essential hypertension. Laboratory tests, which included serum tryptase assay, were normal. Histological analysis showed a normal epidermis with dilated superficial dermal capillaries and no inflammatory infiltrate or dermal elastosis. Amlodipine was discontinued and replaced with ramipril (an ACE inhibitor). The other treatments were changed over and the telangiectasias regressed spontaneously within several months, with no relapse being seen at one year of follow-up.
  
  
  CONCLUSIONS
  Reports of telangiectasia associated with calcium inhibitors most commonly involve the dihydropyridine family, of which amlodipine is a member. Inhibition of muscular contraction induced by this treatment results in vasodilatation, accounting for the associated antihypertensive properties, and this could play a role in telangiectasia formation. The literature contains reports of cases of photo-distributed telangiectasia, suggesting that as well as vasodilatation, calcium inhibitors may in certain cases cause abnormal sensitivity of blood vessels to ultraviolet radiation. The absence of facial lesions rules out the hypothesis of photo-induced lesions in our patient.
authors: UMR 911, Inserm centre de recherche en oncologie biologique et oncophamacologie CRO2, service de dermatologie, hôpital de la Timone, Aix-Marseille université, Assistance Publique des Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France. annesophie.dussouil@gmail.com
authors: A-S
authors: AS
authors: Dussouil
authors: C
authors: C
authors: Gaudy-Marqueste
authors: A-M
authors: AM
authors: Tasei
authors: S
authors: S
authors: Monestier
authors: S
authors: S
authors: Mallet
authors: J-J
authors: JJ
authors: Grob
authors: M-A
authors: MA
authors: Richard
mesh_terms: D017311:Amlodipine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D017298:Bisoprolol / Q000008:administration & dosage / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage / Q000627:therapeutic use; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D008875:Middle Aged; D017257:Ramipril / Q000627:therapeutic use; D013684:Telangiectasis / Q000139:chemically induced* / Q000473:pathology
chemical_list: D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D006852:Hydrochlorothiazide; D017311:Amlodipine; D017257:Ramipril; D017298:Bisoprolol