Background: Bier spots are asymptomatic white anemic macules with irregular shape
located on the upper limbs and less often on the lower limbs and trunkus. They are observed predominantly
in youg males and may be idiopathic or associated with other conditions.
Objective: We report two cases with Bier spots in which videodermatoscopy and nailfold capillaroscopy
Results: Patient 1 was a 34-year-old otherwise healthy male who presented with white spots on his
upper limbs for 10 years. Dermoscopy revealed marked narrowing of skin capillaries within the
borders of white macules whereas capillaroscopy pattern was normal. Patient 2 was a 20-year-old
female with symptoms of Raynaud's phenomenon who presented with white spots on the volar aspects
of her hands for 2 years. The capillaroscopy showed abnormal findings with presence of homogenous
Conclusion: Bier spots do not require any treatment. The associated conditions found should be
Keywords: White anemic macules, dermatoscopy, capillaroscopy, Bier spots, irregular shape, enlarged capillaries.
Rights & PermissionsPrintExport