[Causes and differential diagnosis of flush].
The flush is a transient and recurrent erythema of the upper region of the body, due to a sudden arterial dilatation. First, physicians should confirm the flush and ascertain the location and timing of skin manifestations. The rapid onset and location of the skin rash to the face and anterior chest are the main characteristics of flush. In most of the cases, the flush is emotional, but this should remain a diagnosis of exclusion, as flush may be the presenting manifestation of many systemic or neoplastic disorders. Therefore, a comprehensive diagnostic work-up is necessary, including clinical, biological, and imaging testing. Neoplastic and endocrine causes of flush include VIPoma, carcinoid syndrome, medullary thyroid cancer, mastocytosis, renal cell carcinoma, and pheochromocytoma. Mast cell activation syndrome has been recently described, but it remains a diagnosis of exclusion. This review will first present the different causes of flush, and then will propose a diagnostic algorithm for the physician.
Service de médecine interne, hôpital européen Georges-Pompidou, université Paris Descartes, Paris Sorbonne Cité, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France.
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Lafont
Service de gastroentérologie et nutrition, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, université Pierre-et-Marie-Curie-Paris-6, 75012 Paris, France; Centre de référence des mastocytoses, faculté de médecine, AP-HP Necker-Enfants-Malades, 156, rue de Vaugirard, 75743 Paris cedex 15, France.
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Sokol
Service de dermatologie, hôpital d'Angers, université UNAM, 49100 Angers, France.
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Sarre-Annweiler
Département d'endocrinologie, hôpital Pitié-Salpétrière, université Pierre-et-Marie-Curie, Assistance publique-Hôpitaux de Paris, 75013 Paris, France.
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Lecornet-Sokol
Département de dermatologie-allergologie, hôpital Tenon, université Pierre-et-Marie-Curie, Assistance publique-Hôpitaux de Paris, 75020 Paris, France; Centre de référence des mastocytoses, faculté de médecine, AP-HP Necker-Enfants-Malades, 156, rue de Vaugirard, 75743 Paris cedex 15, France.
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Barete
Centre de référence des mastocytoses, faculté de médecine, AP-HP Necker-Enfants-Malades, 156, rue de Vaugirard, 75743 Paris cedex 15, France; Service d'hématologie adulte, hôpital Necker-Enfants-Malades, université Paris Descartes, Paris Sorbonne Cité, Assistance publique-Hôpitaux de Paris, institut Imagine, 149, rue des Sèvres, 75743 Paris cedex 15, France.
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Hermine
Service de médecine interne, hôpital européen Georges-Pompidou, université Paris Descartes, Paris Sorbonne Cité, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France.
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Pouchot
Service de médecine interne, hôpital européen Georges-Pompidou, université Paris Descartes, Paris Sorbonne Cité, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France; Centre de référence des mastocytoses, faculté de médecine, AP-HP Necker-Enfants-Malades, 156, rue de Vaugirard, 75743 Paris cedex 15, France. Electronic address: s.georgin.lavialle@gmail.com.
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Georgin-Lavialle
D003937:Diagnosis, Differential; D019937:Diagnostic Techniques and Procedures; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis; D005483:Flushing / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D008415:Mastocytosis / Q000150:complications / Q000175:diagnosis; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis; D013577:Syndrome
Carcinoïd; Carcinoïde; Flush; Mastocytose; Mastocytosis; Pheochromocytoma; Phéochromocytome; Vipoma; Vipome; c-Kit