Bier spots in the context of multiple clinical entities and a maneuver for their facial evocation: case report

Fabian-Alfaro Á.C.; Estrella-Saavedra S.; Mariños-Malón A.P.; Valverde-López J.C. · Acta Medica Peruana (2026) · DOI: 10.35663/amp.2026.431.4030

Resumen

Bier spots (BS) are a vasomotor dermatosis characterized by hypopigmented macules on an erythematous and/or cyanotic background. Although usually benign, in some cases, they may reflect an underlying disease. We report the case of a 22-year-old man with BS on the extremities and face, accompanied by palmoplantar hyperhidrosis, varicosities, and an episode of central serous chorioretinopathy, whose coexistence with the latter has not been previously described in the literature. This context suggests a multifactorial pathogenesis involving increased venous pressure, sympathetic hyperactivity, and the venoarteriolar reflex, mechanisms that help explain the accentuation of BS with limb dependency and its attenuation upon elevation. Additionally, a maneuver for eliciting facial BS is described. Management focused on conservative measures for peripheral venous insufficiency.

Instituciones: Universidad Nacional de Trujillo