Petechial angiomata are benign vascular skin tumors, that typically present as flat, irregularly shaped spots ranging from bright red to purple in color, measuring approximately 0.2 to 3 mm in diameter. They are primarily found on the trunk and proximal extremities. We report atypical petechial angiomata with acral involvement in a 75-year-old woman. She had a history of bladder cancer that was treated surgically and had been on raloxifene therapy for osteoporosis for approximately 4 years. Histopathologic finding revealed dilated vascular channels and an enlarged capillary lake within the papillary dermis surrounded by tortuous capillaries. Immunohistochemical analysis showed positivity of CD31 in the entire cell lining, but negativity for D2-40. To our knowledge, acral involvement in petechial angiomata has not been reported previously. Although both the nosology and pathophysiology of this feature remain unclear, endothelial dilation related to long-term raloxifene medication may contribute to the development of atypical vascular lesions.

Petechial angiomata are benign vascular skin tumors, that typically present as flat, irregularly shaped spots ranging from bright red to purple in color, measuring approximately 0.2 to 3 mm in diameter. They are primarily found on the trunk and proximal extremities. We report atypical petechial angiomata with acral involvement in a 75-year-old woman. She had a history of bladder cancer that was treated surgically and had been on raloxifene therapy for osteoporosis for approximately 4 years. Histopathologic finding revealed dilated vascular channels and an enlarged capillary lake within the papillary dermis surrounded by tortuous capillaries. Immunohistochemical analysis showed positivity of CD31 in the entire cell lining, but negativity for D2-40. To our knowledge, acral involvement in petechial angiomata has not been reported previously. Although both the nosology and pathophysiology of this feature remain unclear, endothelial dilation related to long-term raloxifene medication may contribute to the development of atypical vascular lesions.

Petechial angiomata are benign vascular skin tumors, that typically present as flat, irregularly shaped spots ranging from bright red to purple in color, measuring approximately 0.2 to 3 mm in diameter. They are primarily found on the trunk and proximal extremities. We report atypical petechial angiomata with acral involvement in a 75-year-old woman. She had a history of bladder cancer that was treated surgically and had been on raloxifene therapy for osteoporosis for approximately 4 years. Histopathologic finding revealed dilated vascular channels and an enlarged capillary lake within the papillary dermis surrounded by tortuous capillaries. Immunohistochemical analysis showed positivity of CD31 in the entire cell lining, but negativity for D2-40. To our knowledge, acral involvement in petechial angiomata has not been reported previously. Although both the nosology and pathophysiology of this feature remain unclear, endothelial dilation related to long-term raloxifene medication may contribute to the development of atypical vascular lesions.

Petechial angiomata are benign vascular skin tumors, that typically present as flat, irregularly shaped spots ranging from bright red to purple in color, measuring approximately 0.2 to 3 mm in diameter. They are primarily found on the trunk and proximal extremities. We report atypical petechial angiomata with acral involvement in a 75-year-old woman. She had a history of bladder cancer that was treated surgically and had been on raloxifene therapy for osteoporosis for approximately 4 years. Histopathologic finding revealed dilated vascular channels and an enlarged capillary lake within the papillary dermis surrounded by tortuous capillaries. Immunohistochemical analysis showed positivity of CD31 in the entire cell lining, but negativity for D2-40. To our knowledge, acral involvement in petechial angiomata has not been reported previously. Although both the nosology and pathophysiology of this feature remain unclear, endothelial dilation related to long-term raloxifene medication may contribute to the development of atypical vascular lesions.

Complex regional pain syndrome (CRPS) is a chronic neuropathic pain disorder. Pain catastrophizing, characterized by magnification, rumination, and helplessness, increases perceived pain intensity and mental distress in CRPS patients. As functional connectivity patterns in CRPS remain largely unknown, we aimed to investigate functional connectivity alterations in CRPS patients and their association with pain catastrophizing using a whole-brain analysis approach. Twenty-one patients with CRPS and 49 healthy controls were included in the study for clinical assessment and resting-state functional magnetic resonance imaging. Between-group differences in whole-brain functional connectivity were examined through a Network-based Statistics analysis. Associations between altered functional connectivity and the extent of pain catastrophizing were also assessed in CRPS patients. Relative to healthy controls, CRPS patients showed higher levels of functional connectivity in the bilateral somatosensory subnetworks (components 1~2), but lower functional connectivity within the prefronto-posterior cingulate (component 3), prefrontal (component 4), prefronto-parietal (component 5), and thalamo-anterior cingulate (component 6) subnetworks (p<0.05, family-wise error corrected). Higher levels of functional connectivity in components 1~2 (β=0.45, p=0.04) and lower levels of functional connectivity in components 3~6 (β=-0.49, p=0.047) were significantly correlated with higher levels of pain catastrophizing in CRPS patients. Higher functional connectivity in the somatosensory subnetworks implicating exaggerated pain perception and lower functional connectivity in the prefronto-parieto-cingulo-thalamic subnetworks indicating impaired cognitive-affective pain processing may underlie pain catastrophizing in CRPS.