Cutaneous manifestations of orthostatic intolerance syndromes

Caroline T Starling; Quoc-Bao D Nguyen; Ian J Butler; Mohammed T Numan; Adelaide A Hebert

doi:10.1016/j.ijwd.2021.03.003

Cutaneous manifestations of orthostatic intolerance syndromes

Int J Womens Dermatol. 2021 Mar 11;7(4):471-477. doi: 10.1016/j.ijwd.2021.03.003. eCollection 2021 Sep.

Authors

Caroline T Starling¹, Quoc-Bao D Nguyen², Ian J Butler³, Mohammed T Numan³, Adelaide A Hebert^{2

3}

Affiliations

¹ UTHealth McGovern Medical School at Houston, Houston, Texas.
² Department of Dermatology, UTHealth McGovern Medical School at Houston, Houston, Texas.
³ Department of Pediatrics, UTHealth McGovern Medical School at Houston, Houston, Texas.

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.

Keywords: Cutaneous manifestations; Dysautonomia; Hyperhidrosis; Orthostatic intolerance.