Erythrophobia R23.21

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 12.09.2022

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Synonym(s)

Affect erythema; Affective hyperemia; Erythema e irritatione; Erythema e pudore; Erythema iracundiae; erythema pudicitiae; Pubic blush

Definition
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Emotionally triggered, intellectually uncontrollable, flush-like, diffuse redness (possibly also swelling) of the face and lateral neck areas, often accompanied by a non-itching, irregular, macular exanthema. Not infrequently, a vicious cycle of self-monitoring and worrying about sudden uncontrollable blushing develops. Situations that lead to blushing are often deliberately avoided, and the affected person increasingly withdraws. Thus, it is not the actual blushing that is the problem, but the fear of it (see below somatoform disorders).

Manifestation
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Especially in psychovegetatively unstable adolescents. Predominantly occurring in female sexual intercourse.

Localization
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Décolleté, lateral neck and cheek areas, also other sections of the upper torso (e.g. neck).

Clinical features
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Acute, bizarre, 2.0-10.0 cm large, sharply defined, anaemic, bright red spots (erythema), which suddenly appear in an emotional stress situation. The erythema starts uncontrollably and disappears again suddenly after the situation-related excitement phase has subsided. Usually combined with palmar or axillary hyperhidrosis or acrocyanosis.

Diagnosis
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The clinic with the sudden, situational erythema formation is proving.

Differential diagnosis
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Flush of other etiologies (e.g., nutritive, drug, hormonal, neoplastic); erythema perstans faciei; systemic lupus erythematosus.

Therapy
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Trial of beta-blockers.

If drug therapy is not successful and in case of extreme annoyance of a personality with the risk of social isolation: endoscopic transthoracic sympathectomy (ETS): Effective and durable, minimally invasive procedure via endoscopic access. 2 major side effects have been described: postoperative pneumothorax < 2%; passager compensatory sweating < 20%. Caution. Transthoracic sympathectomy can only be performed in centers specialized for this procedure.

Progression/forecast
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The reactivity decreases significantly until the middle of the day!

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 12.09.2022