(blue-white-red vasomotor dermatosis)

(acronym for Bier's Anemic Spots Cyanosis Urticaria-Like Eruption)  

Chronic benign acquired form of vasomotor dermatosis involving electively the lower limbs (sometimes the upper limbs), in the orthostatic immobile position (standing or sitting) and characterized by: 

-        the successive onset of acrocyanosis, with central anemic maculae (known as Bier's maculae) and a pseudo-urticarian orange-red colored eruption located on the maculae; 

-         frequent presence of pruritus, sensitivity or swelling of the affected limbs 

-         rapid reversibility of all symptoms when going back supine

Orthostatic hypotension may be associated.

Anesthetic implications: 

increased risk of hypotension during anesthesia ?

References : 

-        Martin JM, Torres T, Cordero P, Sanchez S et al.
BASCULE syndrome associated with syncopal episodes.
Pediatr Dermatol 2018; 35: e142-3

-        Daneseu S, Baican C, Chiorean R, Filip M et al.
Orthostatic hypotension revealed by BASCULE syndrome.
Eur J Dermatol 2018; 28: 393-5

Updated: October 2019