BASCULE syndrome in a young woman with postural orthostatic tachycardia syndrome.

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Date: Oct. 17, 2022
From: CMAJ: Canadian Medical Association Journal(Vol. 194, Issue 40)
Publisher: CMA Impact Inc.
Document Type: Clinical report
Length: 575 words
Lexile Measure: 1780L

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A 19-year-old woman with idiopathic gastroparesis and a jejunostomy tube presented to hospital with a recurrent pruritic eruption over the legs (Figure 1), which appeared several minutes after standing, with associated lightheadedness and weakness. The skin lesions disappeared minutes after lying down. Fourteen months previously, she had received a diagnosis of postural orthostatic tachycardia syndrome (POTS) confirmed by tilt table testing; her electrocardiogram was normal. Her symptoms were partially controlled with ivabradine and fludrocortisone. Based on the triad of morphologic features triggered by standing (Figure 1), we made a diagnosis of BASCULE (Bier anemic spots, cyanosis, and urticaria-like eruption) syndrome. We prescribed 20 mg of loratadine once daily and she reported an improvement in pruritis.

First reported in 2016, BASCULE syndrome is an uncommon vasomotor dermatosis that occurs most frequently in females aged 12-15 years. (1) It can be mistaken for urticaria, but...

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Gale Document Number: GALE|A722250706