title: Dermatological Manifestations of Postural Tachycardia Syndrome Are Common and Diverse.
abstract: OBJECTIVE
  Postural tachycardia syndrome (POTS) is a syndrome of orthostatic intolerance in the setting of excessive tachycardia with orthostatic challenge, and these symptoms are relieved when recumbent. Apart from symptoms of orthostatic intolerance, there are many other comorbid conditions such as chronic headache, fibromyalgia, gastrointestinal disorders, and sleep disturbances. Dermatological manifestations of POTS are also common and range widely from livedo reticularis to Raynaud's phenomenon.
  
  
  METHODS
  Questionnaires were distributed to 26 patients with POTS who presented to the neurology clinic. They were asked to report on various characteristics of dermatological symptoms, with their answers recorded on a Likert rating scale. Symptoms were considered positive if patients answered with "strongly agree" or "agree", and negative if they answered with "neutral", "strongly disagree", or "disagree".
  
  
  RESULTS
  The most commonly reported symptom was rash (77%). Raynaud's phenomenon was reported by over half of the patients, and about a quarter of patients reported livedo reticularis. The rash was most commonly found on the arms, legs, and trunk. Some patients reported that the rash could spread, and was likely to be pruritic or painful. Very few reported worsening of symptoms on standing.
  
  
  CONCLUSIONS
  The results suggest that dermatological manifestations in POTS vary but are highly prevalent, and are therefore of important diagnostic and therapeutic significance for physicians and patients alike to gain a better understanding thereof. Further research exploring the underlying pathophysiology, incidence, and treatment strategies is necessary.
authors.affiliation: Boston University School of Medicine, Boston, MA, USA. hhuang@bu.edu.
authors.forename: Hao
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Neurology, Boston University Medical Center, Boston, MA, USA.
authors.forename: Anindita
authors.initials: A
authors.lastname: Deb
authors.affiliation: Boston University School of Medicine, Boston, MA, USA.
authors.forename: Collin
authors.initials: C
authors.lastname: Culbertson
authors.affiliation: Boston University School of Medicine, Boston, MA, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Morgenshtern
authors.affiliation: Department of Neurology, Boston University Medical Center, Boston, MA, USA.|Boston University School of Medicine, Boston, MA, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: DePold Hohler
keywords: Raynaud's phenomenon; dermatological manifestations; dysautonomia; livedo reticularis; postural tachycardia syndrome; varicose veins