BASCULE syndrome in children

Authors

  • Daniela Yoseli Puski S.A.M.I.C. Pediatric Hospital “Prof. Dr. Juan P. Garrahan”, City of Buenos Aires, Argentina
  • María Marta Bujan S.A.M.I.C. Pediatric Hospital “Prof. Dr. Juan P. Garrahan”, City of Buenos Aires, Argentina
  • Eliana Cella S.A.M.I.C. Pediatric Hospital “Prof. Dr. Juan P. Garrahan”, City of Buenos Aires, Argentina
  • Andrea Bettina Cervini S.A.M.I.C. Pediatric Hospital “Prof. Dr. Juan P. Garrahan”, City of Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/9ekf2p81

Keywords:

BASCULE syndrome, Bier anemic spots, cyanosis, urticaria

Abstract

BASCULE syndrome is a benign vasomotor dermatosis that is frequently underdiagnosed. It is manifested by transient episodes triggered a few minutes after acquiring the supine position, characterized by erythrocyanosis, anemic Bier spots and an urticaria-like rash (BASCULE). It is more frequent in the lower limbs and may be accompanied by local pain and/or pruritus and orthostatic hypotension. The diagnosis is clinical and there is no specific standardized treatment.

We describe three cases of BASCULE syndrome in two female adolescents, two of them associated with tachycardia and orthostatic hypotension.

The condition is likely underdiagnosed. The clinical awareness of pediatricians is crucial to avoid unnecessary studies.

Author Biographies

  • Daniela Yoseli Puski, S.A.M.I.C. Pediatric Hospital “Prof. Dr. Juan P. Garrahan”, City of Buenos Aires, Argentina

    Chief Resident, Dermatology Service

  • María Marta Bujan, S.A.M.I.C. Pediatric Hospital “Prof. Dr. Juan P. Garrahan”, City of Buenos Aires, Argentina

    Staff Physician, Dermatology Service

  • Eliana Cella, S.A.M.I.C. Pediatric Hospital “Prof. Dr. Juan P. Garrahan”, City of Buenos Aires, Argentina

    Staff Physician, Dermatology Service

  • Andrea Bettina Cervini, S.A.M.I.C. Pediatric Hospital “Prof. Dr. Juan P. Garrahan”, City of Buenos Aires, Argentina

    Head of Service, Dermatology Service

References

I. Ceravalls J, Iglesias-Sancho M, Barrabés-Torrella C, Fernández-Figueras MT. Adult-onset BASCULE syndrome. Actas Dermosifiliogr. 2024;115:T1008-T1009.

II. Reinhart JP, Kumar AB, Casanegra AI, Rooke TW, et al. Bridging the gap in BASCULE syndrome. A retrospective case series of a recently described clinical entity. Pediatr Dermatol. 2024;41:46-50.

III. Baurens N, Briand C, Giovannini-Chami L, De Guillebon De Resnes JM, et al. Case report, practices survey and literature review of an under-recognized pediatric vascular disorder: the BASCULE syndrome. Front Pediatr. 2022;10:849914.

IV. El Nemnom P, Lauwerys B, Marot L, Tennstedt D, et al. Bier anemic spots, cyanosis, and urticaria-like eruption (BASCULE) syndrome: Report of two new cases and literature review. Pediatr Dermatol. 2020; 37:864-867.

V. Bortoluzzi T, Silver S. BASCULE syndrome. A report of three new cases with various associations. SAGE Open Med Case Rep. 2023;11:2050313X231152062.

VI. Liu C, Wong ITY, Au S. BASCULE syndrome in a young woman with postural orthostatic tachycardia syndrome. CMAJ. 2022;194:E1382.

VII. Galindo-Gómez A, Martínez-Osorio D. A 13-year-old boy with BASCULE syndrome and a literature review of the potential causative mechanisms. Eur J Dermatol. 2022; 32:548-549.

VIII. Barbé J, Escobar G, Bursztejn AC. Bier anemic spots, cyanosis with urticaria-like eruption (BASCULE) syndrome: a simple benign pathology, but probably underdiagnosed. Int J Dermatol. 2021;60:1163-1164.

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Published

2026-04-28

Issue

Vol. 32 No. 1 (2026): January-april

Section

Original Articles

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Copyright (c) 2026 On behalf of the authors. Reproduction rights: Argentine Dermatology

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