Flushing

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Flushing
ICD-10 R23.2
ICD-9 782.62

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

For a person to flush is to become markedly red in the face and often other areas of the skin, from various physiological conditions. Flushing is generally distinguished, despite a close physiological relation between them, from blushing, which is milder, generally restricted to the face or cheeks, and generally assumed to reflect embarrassment. Flushing is also a cardinal symptom of carcinoid syndrome – the syndrome that results from hormones (often serotonin or histamine) being secreted into systemic circulation.

Causes

Causes by Organ System

Cardiovascular Accelerated hypertension
Chemical / poisoning No underlying causes
Dermatologic Mastocytosis, Rosacea, POEMS syndrome
Drug Side Effect Acetylcysteine, Acipimox, Adenosine, Agalsidase beta, Ambrisentan, Amlodipine, Amlodipine and Benazepril, Amyl nitrite, Aspirin, Atropine, Aztreonam, Betahistine, Bethanechol chloride, Bosentan, Bromocriptine, Butyl nitrite, Cabergoline, Calcitonin, Calcium channel blockers, Caspofungin, Chlorpropamide, Cholinergics, Corticorelin, Cyclosporin, Cyclosporine, Cyproterone acetate, caspofungin acetate Danazol, Desmopressin, Dinoprostone, Disulfiram, Eletriptan, Epirubicin , Epoprostenol, Erythropoietin, Ethanol, Felodipine, Fenoldopam, Flutemetamol F 18, Flurazepam hydrochloride, Gemeprost, Gestrinone, Glatiramer acetate, Glucarpidase, Glyceryl trinitrate, Granulocyte-macrophage colony stimulating factor, Homatropine, Isosorbide dinitrate, Isosorbide mononitrate, Isoproterenol (aerosol), Isradipine, Licorice, Lysuride, Metaproterenol, Methionine, Metrifonate, Micafungin, Mivacurium chloride, Morphine, Nabilone, Nasal decongestants, Niacin, Nicorandil, Nicotinic acid, Nifedipine, Nitrendipine, Nitroglycerin, Opioids, Oxcarbazepine, Pergolide, Physiological response to vasodilators , Piribedil, Polymyxin B, Probenecid, Prostaglandins, Protamine sulfate, Protirelin, Psychedelics, Quinidine, Ramucirumab, Reboxetine, Regadenoson, Reproterol, Retinoids, Rifampin, Ropinirole, Salbutamol, Secretin human, Serotonin, Sildenafil, Sodium nitrite, Sorafenib, Sulprostone, Tadalafil, Tamoxifen, Teniposide, Thyrotropin releasing hormone, Thyrotrophin releasing peptide, Tretinoin, Triamcinolone, Trilostane, Vancomycin, Vardenafil, Vortioxetine
Ear Nose Throat No underlying causes
Endocrine Carcinoid syndrome, Thyrotoxicosis, POEMS syndrome, Carcinoid tumour, Medullary thyroid carcinoma, Phaeochromocytoma
Environmental No underlying causes
Gastroenterologic WDHA, Pancreatic cancer
Genetic Erythromelalgia
Hematologic Polycythaemia, Polycythaemia rubra vera, Primary thrombocythemia, Thrombocytosis, Basophil chronic granulocytic leukemia
Iatrogenic No underlying causes
Infectious Disease Viral hemorrhagic fever, Yellow fever
Musculoskeletal / Ortho No underlying causes
Neurologic Auriculotemporal nerve syndrome, Frey's syndrome, Harlequin syndrome, Monoamine oxidase deficiency, POEMS syndrome, Spinal autonomic dysreflexia, Trigeminal Neuralgia, Vegetative dystonia, Erythromelalgia
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic Menopausal flushing
Oncologic Adrenal neoplasm, Basophil chronic granulocytic leukemia, Carcinoid tumour, Insulinoma, Medullary thyroid carcinoma, Neuroendocrine tumors, Pancreatic cancer, Phaeochromocytoma, Renal cell carcinoma, VIPoma
Opthalmologic No underlying causes
Overdose / Toxicity Acipimox, Adenosine, Ambrisentan, Amlodipine, Amyl nitrite, Aspirin, Betahistine, Bosentan, Bromocriptine, Butyl nitrite, Cabergoline, Calcitonin, Calcium channel blockers, Caspofungin, Chlorpropamide, Cholinergics, Cyclosporin, Cyclosporine, Cyproterone acetate, Danazol, Dinoprostone, Epoprostenol, Erythropoietin, Ethanol, Felodipine, Fenoldopam, Gemeprost, Gestrinone, Glatiramer acetate, Glyceryl trinitrate, Granulocyte-macrophage colony stimulating factor, Isosorbide dinitrate, Isosorbide mononitrate, Isradipine, Licorice, Lysuride, Methionine, Metrifonate, Micafungin, Morphine, Nasal decongestants, Nicorandil, Nicotinic acid, Nifedipine, Nitrendipine, Nitroglycerin, Opioids, Pergolide, Physiological response to vasodilators , Piribedil, Prostaglandins, Protamine sulfate, Psychedelics, Quinidine,Reboxetine, Regadenoson, Reproterol, Retinoids, Rifampin, Ropinirole, Salbutamol, Serotonin, Sildenafil, Sodium nitrite, Sulprostone, Tadalafil, Tamoxifen, Thyrotropin releasing hormone, Thyrotrophin releasing peptide, Triamcinolone, Trilostane, Vancomycin, Vardenafil
Psychiatric Acute stress disorder, Limerence
Pulmonary No underlying causes
Renal / Electrolyte Hypermagnesemia, WDHA , Renal cell carcinoma
Rheum / Immune / Allergy Allergy, Anaphylaxis, Quincke's edema
Sexual Pseudocarcinoid syndrome in secondary male hypogonadism, Sexual arousal
Trauma No underlying causes
Urologic No underlying causes
Dental No underlying causes
Miscellaneous Alcohol, An abrupt cessation of physical exertion, Anger, Anxiety, Dehydration, Embarrassment, Exercise, Extremes of emotion, Heat, High fever, Hot beverages, Hypertonic crisis, Rapid changes in temperature, Red plums, Spicy foods, Straining, Stress, Tomatoes, Valsalva maneuver, Vigorous coughing

Causes in Alphabetical Order


Sex flush

Commonly referred to as the sex flush, vasocongestion (increased blood flow) of the skin can occur during all four phases of the human sexual response cycle. Studies show that the sex flush occurs in approximately 50-75% of females and 25% of males, yet not consistently. The sex flush tends to occur more often under warmer conditions and may not appear at all under cooler temperatures. It has also been commonly observed that the marked degree of the sex flush can predict the intensity of orgasm to follow.

During the female sex flush, pinkish spots develop under the breasts, then spread to the breasts, torso, face, hands, soles of the feet, and possibly over the entire body. Vasocongestion is also responsible for the darkening of the clitoris and the walls of the vagina during sexual arousal. During the male sex flush, the coloration of the skin develops less consistently than in the female, but typically starts with the epigastrium (upper abdomen), spreads across the chest, then continues to the neck, face, forehead, back, and sometimes, shoulders and forearms.

The sex flush typically disappears soon after orgasm occurs, but this may take up to two hours or so, and sometimes, intense sweating will occur simultaneously. The flush usually diminishes in reverse of which it appeared.

See also

References


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