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Introduction Telangiectatic matting (TM) is a morphological description referring to vessels with a small diameter of less than 0.2 mm that can appear sporadically or in well-defined patches (hence the term ‘matting’) primarily on the lower limbs. The aetiology underlying TM remains uncertain however angiogenic and inflammatory mechanisms are believed to play a pathogenic role. The aim of this study was to investigate the pathogenesis of TM and identify possible risk factors. Methods This study had two parts. The clinical records of consecutive patients were retrospectively analysed to identify risk factors for TM. In the second part, the haemostatic and coagulation profile of 12 patients with TM were analysed and compared with 12 controls using standard coagulation tests, platelet function and a global assay of coagulation namely rotational thromboelastometry (ROTEM). Results In 352 consecutive patients presenting to a phlebology practice, 25 patients had TM (7.1%). All 25 patients were female with the median age of 45 (27-57) years. A comprehensive medical history was taken. Amongst 27 possible risk factors assessed, statistically significant associations included recurrent epistaxis, easy bruising, hypersensitivity (eczema, hives, hay fever, rhinitis), previous treatment with sclerotherapy or vascular laser for lower limb veins and a family history of telangiectasias. The haemostatic and coagulation profile of patients with TM did not differ significantly from those without TM. Conclusion TM is associated with both hypersensitivity and a bleeding tendency. Our study revealed no significant increase in the incidence of haemostatic abnormalities in patients with TM compared with the control group. Given the significant association with hypersensitivity disorders we believe underlying mast cell hyperreactivity may contribute to both hypersensitivity and a bleeding tendency and predispose patients to TM. Further research studying mast cell activity is warranted to establish a definite link. |
