Widespread Progressive Telangiectasia in a 54-Year-Old Caucasian Male

Telangiectasia macularis multiplex acquisita (TMMA) is a rarely reported cutaneous vascular disorder characterised by widespread telangiectatic macules, most commonly affecting middle-aged adults. It has been reported predominantly in East Asian populations, particularly in Chinese and Korean cohorts. TMMA has also been observed in association with systemic conditions, including chronic liver disease, hypertension, type 2 diabetes mellitus, and dyslipidaemia. We present a case of a 54-year-old Caucasian male with progressive, symmetrical telangiectatic lesions affecting the face, upper limbs, and trunk. He reported chronic elevated alcohol intake and a history of significant sun exposure. Laboratory investigations were unremarkable. Histopathological examination confirmed superficial dermal telangiectasia without mast cell proliferation, consistent with TMMA. The patient was referred to a photodermatology specialist and managed conservatively with lifestyle modification. This case contributes to the limited English-language literature on TMMA and underscores the importance of distinguishing it from mimics such as telangiectasia macularis eruptiva perstans (TMEP).