Reviews in Endocrine and Metabolic Disorders

, Volume 17, Issue 3, pp 373–380 | Cite as

Flushing in (neuro)endocrinology

  • Fady Hannah-Shmouni
  • Constantine A. Stratakis
  • Christian A. Koch


Cutaneous flushing is a common presenting complaint in endocrine disorders. The pathophysiology of flushing involves changes in cutaneous blood flow triggered by multiple intrinsic factors that are either related to physiology or disease. Flushing can be divided into episodic or persistent causes. Episodic flushing is mediated by the release of endogenous vasoactive mediators or medications, while persistent flushing results in a fixed facial erythema with telangiectasia and cyanosis due to slow-flowing deoxygenated blood in large cutaneous blood vessels. The differential diagnosis of cutaneous flushing in neuroendocrine disorders is limited, yet encompasses a broad spectrum of benign and malignant entities, including carcinoid syndrome, pheochromocytoma, Cushing syndrome, medullary thyroid cancer, and pancreatic neuroendocrine tumors. In this review, we provide a concise and up-to-date discussion on the differential diagnosis and approach of flushing in neuroendocrinology.


Flushing Neuroendocrine tumor Carcinoid Pheochromocytoma Histamine Substance P 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York (outside the USA) 2016

Authors and Affiliations

  1. 1.Section on Endocrinology & Genetics (SEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)National Institutes of Health (NIH)BethesdaUSA
  2. 2.Division of EndocrinologyUniversity of Mississippi Medical CenterJacksonUSA
  3. 3.G.V. (Sonny) Montgomery VA Medical CenterJacksonUSA

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