Osler–Weber–Rendu syndrome
==============================

* John A.M. Morphet

The attached image (Fig. 1) is intended to complement the pulmonary radiography and CT imaging that accompany the report of a case of hereditary hemorrhagic telangiectasia described by Narinder Pal Singh and colleagues.1

It is this observer's experience that telangiectasia have a predilection for the skin of the face and tend to intensify with advancing years. Anatomically, the signature mucocutaneous vascular lesions consist of dilatations of the capillaries and venules that, importantly, blanch on pressure. Red to purplish, they are usually pinpoint sized but may be frankly nodular, as depicted (Fig. 1).

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/175/10/1243.1/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/175/10/1243.1/F1)

Fig. 1: Facial telangiectasia.

Hence, these dermal markers alert physicians to the possibility of concomitant visceral arteriovenous fistulae, which interestingly can also involve the myocardium,2 mimicking coronary heart disease.

## REFERENCES

1.  1. Singh NP, Gulati S, Garg S, et al. A woman with an unusual case of hemoptysis. CMAJ 2006;175:242-3.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czo5OiIxNzUvMy8yNDIiO3M6NDoiYXRvbSI7czoyNDoiL2NtYWovMTc1LzEwLzEyNDMuMS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=) 

2.  2. Miller CL. Murphy ML. Hereditary hemorrhagic telangiectasia: demonstration of a myocardial lesion by postmortem coronary angiography [abstract]. J Arkansas Med Soc 1976;73:64.