Acquired unilateral nevoid telangiectasia syndrome accompanied by chronic hepatitis B virus infection.

Unilateral nevoid telangiectasia syndrome (UNTS) is a rare disease characterized by superficial telangiectasias in a dermatomal distribution. It is generally unilateral and frequently distributed in the C3-C4 or trigeminal nerve dermatomes (1). There are various opinions on the pathogenesis, which can be congenital or acquired. Here, we intended to make a new contribution to the pathogenesis of the disease by presenting a male patient with UNTS accompanied by chronic hepatitis B virus infection. An 18-year-old male patient presented to our outpatient clinic with asymptomatic telangiectasias that appeared 3 years previously and increased gradually. He had no systemic diseases or history of alcohol consumption. Physical examination was normal. Dermatologic examination revealed a few fine, branching unilateral telangiectasias located on the left half of the upper lip, left upper and lower eyelids, and left side of the neck, which were in accordance with the C3 dermatome, ophthalmic and maxillary branches of the trigeminal nerve (Fig. 1a, b). Complete blood count, erythrocyte sedimentation rate, urine analysis, renal and hepatic parameters, thyroid function tests, bleeding and coagulation parameters, blood estrogen level, anti-nuclear antibody and thyroid autoantibodies, and HIV serology were within the normal range. Hepatitis B surface antigen (HBsAg), HBVe antibodies and HBV-DNA were positive, which led to the diagnosis of chronic hepatitis B. There was no evidence of liver cirrhosis. Punch biopsy of the lesional skin revealed fine, dilated vessels located in the middle and upper dermis (Fig. 2). Immune reactivity was negative for estrogen and progesterone receptors. Taking into consideration the distribution of the lesions, histopathology and laboratory test results, the patient was diagnosed as UNTS accompanied by chronic hepatitis B. UNTS is thought to be associated with physiological and pathological hyperestrogenemic states such as pregnancy, puberty, hepatic disease, and hormonal therapy. However, Wenson et al. (1) showed that hormonal theory was not valid for all cases and there