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endoyoo Group

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Nicholas Cook
Nicholas Cook

Rubor !!INSTALL!!

Background: Skin rubor, or reddish discoloration on skin, is a sign of irritation. Physiologically it involves temporary vasodilation and hyperaemia in tissue, and is diagnosed by the visible characteristics.


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Methods: Five healthy women (22-25 years) participated in the experiments. Four were ethanol patch test (EPT)-positive; one was negative. A skin rubor was developed on the subjects' left forearm by temporary vasodilatation, which was caused by a dermal inflammation reaction due to application of ethanol to the skin. BIA was then conducted for the skin rubor and the intact skin using a lock-in amplifier with a frequency range of 0.1Hz-10kHz. The impedance changes due to vasodilatation of capillary were evaluated.

Results: The resistance of the skin rubor was found to decrease to almost 90% of the resistance and 87% of the reactance of the intact skin in the EPT-positive subjects. There was no impedance change in the EPT-negative subject. Through these experiments, skin rubor could be distinguished from intact skin based on the electrical impedance.

Las personas que toman ciertos medicamentos que alteran el metabolismo del alcohol también pueden experimentar la reacción de rubor al alcohol. Tales medicamentos incluyen los que se usan para tratar la diabetes, el colesterol alto y las infecciones. Además, el disulfiram, un medicamento utilizado para tratar el trastorno por consumo de alcohol (AUD, por su sigla en inglés) altera el metabolismo del alcohol causando que el acetaldehído se acumule cuando una persona bebe alcohol. Esto produce síntomas desagradables como rubor y náuseas. El deseo de evitar esos efectos desagradables puede alentar a algunas personas a abstenerse de beber.

Discussion: Dependent rubor or erythema is stigmata of peripheral arterial disease involving the erythematous discoloration of the limb in dependent position due to the effect of gravity.(1) It is a significant physical exam finding as dependent rubor is often misdiagnosed as cellulitis leading to inappropriate use of antibiotics. It is associated with increased risk of progression to limb-threatening state. (2) It occurs as the arterioles are maximally dilated as a compensatory response to ischemia and fail to constrict despite the hydrostatic pressure being high when the limb is in the dependent position. Buerger test, as it is known, is a simple yet rarely performed test which can help differentiate cellulitis from arterial insufficiency. (3)

Conclusions: Dependent rubor can be diagnosed on prudent physical examination using Buerger test, thus minimizing unnecessary antibiotic use. Moreover, it requires prompt initiation of PAD treatment as it denotes severe arterial insufficiency.

Clinical findings of little value: Berger's Test (Examining the leg after elevation and then in a dependent position. With elevation, the foot turns pale and there can be venous guttering (all the blood has drained out of the veins). When in a dependent position, the foot turns brightly red, called rubor, before returning to a normal pink color. This clinical test, when positive, is a good predictor of a patient have PAD and CLI, but when negative, it does not mean there is not significant PAD or CLI.

convivium; cum re autem: pedum crepitus, strepitus hominum, corporum umbrae et si quid eius modi; at post rem: pallor, rubor, titubatio, si qua alia signa conturbationis et conscientiae, praeterea restinctus ignis, gladius cruentus

When below heart level, the foot may appear dusky red (called dependent rubor). In some patients, elevating the foot causes loss of color and worsens ischemic pain; when the foot is lowered, venous filling is prolonged (> 15 seconds). Edema is usually not present unless the patient has kept the leg immobile and in a dependent position to relieve pain. Patients with chronic PAD may have thin, pale (atrophic) skin with hair thinning or loss. Distal legs and feet may feel cool. The affected leg may sweat excessively and become cyanotic, probably because of sympathetic nerve overactivity. 041b061a72


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