Bier's spots are asymptomatic and permanent white macules, standing on a cyanotic background. These spots are associated with venous stasis and usually appear in physiological conditions. We report the case of a 47-year-old woman with a 2-year history of systemic scleroderma, who developed Bier's white spots associated with a vascular and renal crisis. Interestingly, these spots appeared with the crisis, and disappeared with the treatment and resolution of the crisis. They are probably a result of anatomical and functional damage to the small vessels of the skin. The pathophysiology in the skin is probably the same as that which happens in renal vessels during scleroderma renal crisis.
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2230.2006.02298.x/abstractI also read that they have also been associated with some sort of aorta problem.
and: Bier spots constitute a distinct pattern of vascular mottling composed of small, irregular maculae, often triggered by external compression of the limb.1 The spots are caused by a vasoconstriction in microvessels caused by a lack of oxygen2-3 and are therefore regarded as a nonphysiologic phenomenon precipitated by vascular occlusion. Herein we describe a macular vascular pattern of the skin resembling Bier spots that may develop spontaneously during mild venous stasis.
From 1995 to 1999 we identified 8 patients (5 women, 3 men; aged 19-35 years) with spontaneous Bier spots among the patients referred to our department. In 3 patients the spots were the primary object of concern; the other patients inquired about the origin of the spots during consultations pertaining to other skin problems. In 1 patient the spots appeared during pregnancy. The patients had no other complaints suggesting vascular disease.
http://archderm.ama-assn.org/cgi/content/extract/136/5/674-a
