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PubMed1987

Effect of naltrexone on ethanol-provoked flushing in Oriental and white subjects.

The effect of naltrexone vs. placebo on alcohol-provoked flushing was studied in 20 healthy subjects of Oriental ancestry and 20 healthy white subjects. The intensity of the flushing reactions was assessed by two independent methods, the cutaneous perfusion index by laser Doppler velocimetry and the change in malar thermal circulation index by telethermometry. No effect of naltrexone on alcohol-provoked flushing was detected with either method in either racial group. The incidence of abdominal discomfort and nausea associated with naltrexone treatment was much greater among Orientals than whites.

Adult↗
PubMed1986

Chlorpropamide-alcohol flush reaction and isoenzyme profiles of alcohol dehydrogenase and aldehyde dehydrogenase.

To investigate the enzymatic basis of the chlorpropamide-alcohol flush reaction (CPAF) we compared the isoenzyme profiles of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) from liver biopsies, and of ALDH alone from erythrocytes and leucocytes, in CPAF-positive and CPAF-negative subjects. No differences were seen in ADH or ALDH phenotypes, or in the relative activities of the isoenzymes, between the two groups before chlorpropamide was given; in particular, no subjects showed the 'null' ALDH phenotype that is associated with the alcohol flush reaction in oriental subjects. There was a significant decrease in erythrocyte ALDH activity after 7 days' treatment with chlorpropamide in CPAF-positive individuals but no such difference was seen in CPAF-negative subjects. These results indicate that CPAF has a different enzymatic basis from the alcohol flush reaction of oriental subjects and suggest that in CPAF-positive subjects erythrocyte ALDH may be particularly susceptible to inhibition by chlorpropamide.

Alcohol Dehydrogenase↗
PubMed2003

Successful use of Botulinum toxin-A for the treatment of neck and anterior chest wall flushing.

Neck and anterior chest wall flushing can be a social handicap to the sufferer and current treatment options are often unsatisfactory. We report the case of a 48-year-old woman with severe flushing of the anterior neck and anterior chest wall which resolved after three treatments of intracutaneous botulinum toxin A injections. We believe that this treatment method for skin flushing is simple, effective and free of significant side effects at these sites. Further studies are needed to evaluate the duration of the therapeutic effect.

Botulinum Toxins, Type A↗
PubMed1991

The butterfly rash and the malar flush. What diseases do these signs reflect?

The butterfly rash and malar flush are common facial manifestations of several disorders. Systemic lupus erythematosus may produce a transient rash before any other signs. In pellagra, symmetric keratotic areas on the face are always accompanied by lesions elsewhere on the body. Erysipelas produces brawny, fiery red facial lesions, and scarlet fever causes facial eruptions as part of a generalized eruption. Lupus vulgaris and lupus pernio produce nodules that may spread in a butterfly pattern, and seborrheic dermatitis has a predilection for the malar prominences and other areas of the face. Carcinoid syndrome often causes flushing attacks that vary in duration, and facial flushing that lasts throughout treatment may accompany chemotherapy if the patient has a hypersensitivity reaction. Deep-red rashes and/or lichenoid lesions may be caused by graft-versus-host disease in a patient undergoing bone marrow transplantation.

Dermatitis, Seborrheic↗
PubMed1989

Endocrinological basis of hot flushes.

Hot flushes are frequent among women during natural, surgical, or pharmacological menopause. The available data suggest the involvement of estrogens, progestins, catecholestrogens, catecholamines, dopamine, endorphins, prostaglandins, luteinizing hormone (LH) and luteinizing hormone-releasing hormone (LH-RH) in the pathogenesis of flushes. At present the estrogen withdrawal and pulsatile luteinizing hormone (LH) secretion theories are most commonly accepted for explaining the development of this symptom. The use of LH-RH agonists offers an opportunity to focus on the probable origin and region that regulate the events of this phenomena, since the administration of this drug is associated with hot flushes, in spite of low gonadotropins and normal estrogen levels. Current data may suggest that the origin of this neurovegetative symptom lies in the hypothalamus.

Climacteric↗
PubMed1984

Characterization of patients with chlorpropamide-alcohol flush.

One hundred and sixty patients with onset of non-ketotic diabetes at the ages of 35-70 were investigated for chlorpropamide-alcohol flush (CPAF), beta-cell function, insulin sensitivity, human leucocyte antigens (HLA), organ specific antibodies and diabetic complications. A positive flush reaction was defined as an increase in facial skin temperature by at least 1.5 degrees C, which was associated with a visible flush reaction in all patients. In accordance with these criteria, 38% of the patients were considered CPAF-positive with a mean rise in facial skin temperature of 2.3 +/- 0.1 degrees C compared with 0.6 +/- 0.1 degrees C in the CPAF-negative patients (p less than 0.001). The CPAF-positive patients could be distinguished from the CPAF-negative with respect to: 1) higher frequency of first degree family history of diabetes (p less than 0.05), 2) lower basal and glucagon-stimulated C-peptide concentrations (p less than 0.02 and p less than 0.001), 3) increased frequency of HLA-A2 (p less than 0.01) and decreased frequency of HLA-B7 (p less than 0.01). The findings thus support the genetically determined nature of CPAF. Considering the criteria for maturity onset diabetes in the young, it is unlikely that CPAF acts as a genetic marker for this particular form of genetic diabetes.

Adult↗
PubMed1985

Facial skin temperature in chlorpropamide alcohol flush.

Objective methods to study the chlorpropamide alcohol flush (CPAF) have been inadequate. Determination of blood acetaldehyde has proved to be a promising method, but the analysis is difficult and time-consuming. To measure the facial skin temperature is more handy. The results of these measurements can be presented as delta T (skin temperature increase), %T (per cent of maximum possible temperature rise) or delta MTCI (malar thermal circulation index) after calculations. The baseline skin temperature is accounted for in %T and delta MTCI. Blood acetaldehyde determinations and placebo-alcohol tests can be used to separate the CPAF reaction from alcohol flushing. Single dose CPAF tests including facial skin temperature measurements were performed in 133 type 2 (non-insulin dependent) diabetics. Facial flush was observed in 42.9%. The specificity and sensitivity of all three skin temperature methods were high: 88.2, 85.5, 96.1%, and 89.5, 86.0, 86.0%, respectively. Skin temperature measurement, whether expressed as delta T, %T or delta MTCI, provides a method to study CPAF with high accuracy.

Adolescent↗
PubMed1988

Opiate antagonist nalmefene inhibits ethanol-induced flushing in Asians: a preliminary study.

Ethanol-induced flushing (EIF) occurs in up to 80% of Asians and is characterized by facial flushing, tachycardia, and increased cardiac output. Since endogenous opiates and prostaglandins may be mediators of flushing syndromes, we attempted to block EIF in four Asian flushers with single doses of either the opiate antagonist nalmefene, or the prostaglandin synthesis inhibitor indomethacin. Nonflushers (2 Caucasian, 2 Asian) and four Asian flushers were given on separate days water, ethanol (0.4 g/kg p.o.), ethanol plus nalmefene (2 mg i.v.), or ethanol plus indomethacin (50 mg p.o.). Ethanol concentrations of flushers and nonflushers were similar. Mean (+/- SEM) plasma acetaldehyde concentrations of flushers (28.2 +/- 11.8 microM) were significantly greater than nonflushers (1.4 +/- 0.5 microM) following ethanol ingestion (p less than 0.001). Ethanol alone always induced a significant rise in facial skin temperature [mean area under the curve (AUC) = 5142 +/- 648 % delta T x min, p less than 0.01] and of pulse (mean AUC = 1622 +/- 120 bpm x min, p less than 0.001) in flushers compared to water ingestion. A single dose of nalmefene (2 mg i.v.) but not indomethacin (50 mg p.o.), reduced the mean (+/- SEM) ethanol-induced rise in facial skin temperature of flushers by 58 +/- 14% (p less than 0.05) without changing plasma acetaldehyde concentrations. These data are preliminary evidence that the opiate antagonist, nalmefene, blocks some of the vascular manifestations of EIF without altering the elevated plasma concentrations of acetaldehyde.

Acetaldehyde↗
PubMed1992

Veralipride for hot flushes during gonadotropin-releasing hormone agonist treatment.

Hot flushes are the commonest symptom induced by gonadotropin-releasing hormone agonists (GnRHa). We performed an open observational trial to evaluate the efficacy of veralipride, an antidopaminergic drug, in reducing hot flushes in 25 premenopausal women treated with a GnRHa for endometriosis (8 subjects) or menorrhagia (17 subjects). The patients received goserelin depot for 6 months and veralipride was added for the third month. Hot flushes, severe in all women at 2 months, improved in both frequency and intensity in 92% of the subjects during veralipride administration. The benefit obtained persisted until the end of the GnRHa treatment.

Adult↗
PubMed1997

[Analysis of flushing response to alcohol and drinking behavior in Japanese male students].

The purpose of this study is to clarify the relationship between hereditary predisposition and social-psychological factors in terms of drinking behavior of Japanese male students. The subjects were 123 male students who belonged to athletic clubs of K university in 1993. Regular drinking was evaluated as "drinking at home or with intimate friends" and party drinking as "drinking at club parties". On the two drinking occasions, the frequency and amount of drinking, and social drinking behavior were evaluated. Problem drinking behavior was investigated by a modified version of Aoyama's questionnaire (1984). Low Km aldehyde dehydrogenase (ALDH2) activity was evaluated by the facial flushing response to alcohol and the ethanol patch test. Evaluable results of the ethanol test as well as replies of the questionnaire were obtained from 109 students. Twenty-three students positive for both the facial flushing response to alcohol and the ethanol patch test were considered to be flushers, and 42 negative for both to be non-flushers. The non-flushers consumed a higher amount of alcohol than the flushers did on drinking occasions at home or with intimate friends. The number of problem drinking behavior items in the non-flushers was significantly higher than that in the flushers and increased with the amount and frequency of drinking. The ratio of students who had inappropriate drinking motivations, began to drink by themselves, or continued to offer alcohol to drinkers showing flushing even when they declined it, was significantly higher in the non-flushers than in the flushers. In addition, non-flushers showing such social drinking behavior drank more than those not showing such behavior. The frequency of positive or inappropriate drinking behavior was significantly lower in the flushers than in the non-flushers. However, the amount and frequency of drinking and problem drinking behavior were similar in the flushers and non-flushers. These results indicate that social drinking behavior of non-flushers influences not only themselves but also other drinkers, and that drinking of flushers is strongly influenced by social factors.

Adult↗
PubMed1985

Alcohol-induced facial flushing and drinking behavior in Japanese men.

The drinking behavior and alcohol-induced facial flushing of 1646 Japanese men (50.9% flushers and 48.0% nonflushers) were analyzed from questionnaires completed by their wives. The results indicate a relationship between flushing and various indices of sensitivity to alcohol and low rates of alcohol-related problems. It is proposed that alcohol-induced flushing acts as an inhibitory factor against excessive alcohol use and consequent problems due to drinking.

Adult↗
PubMed1996

Flushing pattern and idiopathic avascular necrosis of the femoral head.

A cooperative hospital-based case-control study of idiopathic avascular necrosis of the femoral head (IANF) was carried out to clarify the involvement of smoking, drinking, flushing pattern, and other factors in the development of IANF comparing 90 cases (64 males and 26 females) without history of systemic corticosteroid use with 180 matched controls (128 males and 52 females). The results of analyses were represented only for male subjects because of small number of female cases. There was no significant difference in smoking habits, daily and cumulative number of cigarettes smoked between case and control groups. Current drinkers had obviously higher risk (OR = 11.47) of IANF compared to nondrinkers or exdrinkers. In addition, there was a consistent risk increase with increasing alcohol consumption and the highly significant dose-response relationship remained unchanged after adjustment for all other factors (chi 2 = 14.33, p < 0.001 and chi 2 = 13.24, p < 0.001 for daily and cumulative alcohol consumption, respectively). For flushing pattern, although nonflushers had a significantly elevated risk (OR = 2.08) in the univariate analysis, the association disappeared (OR = 0.73) after adjustment for alcohol and other factors. Since nonflushers tend to be heavy drinkers, perhaps, an apparent risk increase among nonflushers may be due to alcohol drinking. Body mass index (BMI) was inversely related to the development of IANF. The risk reduction was found among subjects with higher BMI and an adjusted linear trend of OR was significant (chi 2 = 6.65, p < 0.05). However, further studies were required regarding the association between flushing pattern or BMI and IANF because of a few reports. History of liver diseases and occupational history were not significantly associated with the development of IANF after adjustment for other factors.

Adult↗
PubMed1986

alpha-Methyldopa for climacteric hot flushes. A double-blind, randomized, cross-over study.

The effects of single evening doses of alpha-methyldopa and placebo have been compared in 40 women with climacteric hot flushes. The study was designed as a double-blind, randomized and cross-over investigation. Of the 24 patients who completed the study, 15 reported that they preferred the alpha-methyldopa treatment (p greater than 0.05). alpha-methyldopa seemed to affect both the severity (p less than 0.05) and the frequency of climacteric hot flushes (p greater than 0.05). It is concluded that alpha-methyldopa is efficacious against climacteric hot flushes when given as single evening doses, but further study is required to answer whether this dosage is as effective as a twice daily regimen.

Climacteric↗
PubMedDate not supplied

Flush symptoms caused by a mesenteric carcinoid without liver metastases.

Flushing is a known symptom in intestinal carcinoid tumors which usually occurs only in the presence of liver metastases. A 62-year-old women presented with abdominal pain, nausea and flush symptoms. US, CT, octreotide scintigraphy and biopsy revealed a primary mesenteric carcinoid with retroperitoneal lymph node metastases and a solitary leftsided supraclavicular lymph node metastasis proving lymphatic spread over the thoracic duct, but liver metastases were excluded. This is a report on a mesenteric carcinoid which lead to flush symptoms despite absence of liver metastases, since retroperitoneal lymph node metastases enabled a direct hormone release into the systemic circulation.

Biopsy↗
PubMed1989

[Cyproterone acetate in the treatment of post-orchiectomy flushing].

Out of 17 patients who had been submitted to subcapsular orchidectomy as the primary treatment of cancer of the prostate, postorchiectomy flushing was found in eight, corresponding to 47%. Six of the patients were treated with cyproterone acetate in a dosage of 50-100 mg daily. In all of these clinically significant reduction in the frequency and duration of the flushing was found. In four out of five patients with possible recurrent flushing after withdrawal of cyproterone acetate, recommencement of the treatment proved necessary. Administration of cyproterone acetate appears to be equally effective in a dosage of 100 mg daily as in a dosage of 300 mg daily and this reduces the side effects and expenses considerably. If it is possible to obtain a more extensive patient material without hormone treatment, a placebo-controlled investigation with the reduced dosage is desirable.

Aged↗
PubMed1986

Quantitative assessment of alcohol-provoked flushing.

Objective measurements of temperature and blood flow changes by telethermometry and laser Doppler velocimetry (LDV), respectively, were performed continuously in normal subjects after they ingested 0.4 g/kg of ethanol in a volume of 300 mL. Cutaneous temperatures were interpreted by the change in malar thermal circulation index (delta MTCI) method. Both the delta MTCI method and LDV output correlated significantly with the presence of flushing. The delta MTCI method also correlated significantly with LDV output, indicating that the intensity of the flushing reaction can be assessed by both methods. The sensitivity, specificity, and predictive value of a positive result were greater with the LDV method. The time to maximum delta MTCI correlated quite closely with the time to maximum LDV output. The results indicate that both LDV and delta MTCI methods are valid, noninvasive assays for flushing reactions.

Ethanol↗
PubMed1997

Localized facial flushing in infancy. Auriculotemporal nerve (Frey) syndrome.

BACKGROUND: Patients with auriculotemporal nerve syndrome (Frey syndrome) have facial flushing, sweating, or both localized to the distribution of the auriculotemporal nerve that occurs in response to gustatory stimuli. In adults, the syndrome usually results from surgical injury or trauma to the parotid gland. The condition is rare in infants, but usually manifests during infancy with the introduction of solid food, thus leading to the misdiagnosis of food allergy by physicians unfamiliar with the syndrome. OBSERVATIONS: We describe 8 children with auriculotemporal nerve syndrome who manifested with flushing only. The reaction was erroneously attributed to food allergy in most cases. Six of the 8 patients were delivered with forceps assistance. The remaining 2 patients, with disease onset during the first 3 months of life, had bilateral involvement without known trauma. CONCLUSIONS: Auriculotemporal nerve syndrome may manifest during infancy as flushing with eating food. In contrast to the syndrome in adults, gustatory sweating is rarely associated. The known use of forceps to assist in the delivery of at least 14 of the 28 previously reported pediatric cases and in 6 of our 8 patients suggests that trauma to the parotid region may be responsible for the condition in most infants, as it is in adults. Auriculotemporal nerve syndrome in infancy should be recognized as a benign condition that often resolves spontaneously. Treatment is ineffective and unnecessary.

Birth Injuries↗
PubMed1997

[Acute mast cell leukemia disclosed by vasomotor flushing].

INTRODUCTION: Acute mast cell leukemia is a rare and severe disease. We report herein a case associated with a flush syndrome. CASE REPORT: A 44-year-old man, presented with a flush of face and trunk. Bone marrow was infiltrated with immature mast cells. In spite of chemotherapy and bone marrow transplantation the patient deceased. DISCUSSION: Pheochromocytoma, carcinoid tumor, and mastocytosis are associated with a flush syndrome. In our patient the diagnosis was an acute mast cell leukemia. Acute mast cell leukemia can follow systemic mastocytosis or occur de novo. This disease is of poor prognosis. No treatment is available.

Adult↗