Cutaneous manifestations of orthostatic intolerance syndromes

Abstract

Dysautonomia refers to a group of autonomic nervous system disorders that affect nearly 70 million people worldwide. One subset of dysautonomia includes syndromes of orthostatic intolerance (OI), which primarily affect adolescents and women of childbearing age. Due to the variability in disease presentation, the average time from symptom onset to diagnosis of dysautonomia is 6 years. In general, there is a paucity of dermatological research articles describing patients with dysautonomia. The objective of this review is to summarize the existing literature on cutaneous manifestations in dysautonomia, with an emphasis on syndromes of OI . A PubMed database of the English-language literature (1970–2020) was searched using the terms “dysautonomia”, “orthostatic intolerance”, “cutaneous”, “skin”, “hyperhidrosis”, “hypohidrosis”, “sweat”, and other synonyms. Results showed that cutaneous manifestations of orthostatic intolerance are common and varied, with one paper citing up to 85% of patients with OI having at least one cutaneous symptom. Recognition of dermatological complaints may lead to an earlier diagnosis of orthostatic intolerance, as well as other comorbid conditions.

A case of erythromelalgia with gastrointestinal dysautonomia treated with immunoglobulin: A case report

“…In this case, the outcome was within normal limits, signifying that the patient did not exhibit orthostatic intolerance or other variants of autonomic dysfunction that could contribute to her symptomatology. 14 We sought to detect anomalies in muscle structure or function indicative of a neuromuscular disorder. 15 Since the epidermal nerve density was at the lower threshold of the normal range, it is uncertain whether the patient's symptoms were attributable to a structural abnormality.…”