Venous Garland of Sahli

This skin manifestation was found in a 77-year-old male former smoker (60 pack-years) with severe chronic obstructive pulmonary disease (Global Initiative for Chronic Obstructive Lung Disease [GOLD] stage IV D), as well as chronic hypoxemic and hypercapnic respiratory failure. The skin changes are venous vasodilations in a garland-like arrangement in the region of the lower thoracic aperture. They are typically associated with pulmonary emphysema but may also occur in, for example, mediastinal tumors with venous inflow congestion. However, they are not always necessarily associated with an internal disease: particularly in men of advanced age, this phenomenon can develop as part of the skin aging process. The skin change is named after the Swiss internal medicine specialist, Hermann Sahli (1856–1933), who described it as a “zone of dilated skin vessels near the lower border of the lung.”

Figure

Dr. med. Moritz Schiemer, Klinik für Innere Medizin II – Gastroenterologie, Hepatologie, Endokrinologie, Infektiologie, Universitätsklinikum Freiburg, [e-mail]

Dr. med. Tilmann Schlaich, Prof. Dr. med. Daiana Stolz, Klinik für Pneumologie, Universitätsklinikum Freiburg

Conflict of interest statement: The authors state that no conflict of interest exists.

Translated from the original German by Christine Rye.

Cite this as: Schiemer M, Schlaich T, Stolz D: Venous garland of Sahli. Dtsch Arztebl Int 2022; 119: 483b. DOI: 10.3238/arztebl.m2022.0089