A Study of the Cutaneous Effects of Serotonin**From the Department of Dermatology, Walter Reed Army Institute of Research, Washington, D. C

Patients with metastatic carcinoid tumors may manifest a symptom complex referred to as the malignant carcinoid syndrome. These patients classically demonstrate cutaneous changes characterized by transient flushing (predominantly of the face) with areas of macular cyanosis within the flush. The central areas of the flush tend to fade, leaving erythema, blanching, and cyanosis. This phenomenon has been termed a red, white and blue response. Telangiectatic venules appear as the flushing becomes chronic. Evidence of edema formation has been noted only occasionally.