A case of acrocyanosis in a painting of the 17th century.

Dear Editor,

The Mystic Marriage of St. Catherine (1610–1629) by Italian artist Giovanni Battista Crespi (Il Cerano, 1565–1632) has been recently exposed at the Sinebrychoff Art Museum, in Helsinki (“Collections on tour,” 11.2.2021–9.1.2022). Crespi’s paintings focus on mysteries and mystical episodes in saintly life. The “Mystic marriage” is a religious allegory originating from the 16th century, which illustrates the bond between God and Man. In Arts, female Saints are represented as marrying Christ, mainly the Child Jesus to keep the purity of the allegory.

The author analysed the painting live as previously described. In the aforementioned masterpiece, the painting is composed by three characters, two adults and a toddler. On the left, the Virgin Mary can be identified by her red and blues clothes, while St. Catherine of Alexandria on the right displays two of her usual attributes: a crown and a quill in her right hand. The Virgin Mary surrounds with one hand the Child Jesus and, with the other, holds the left hand of St. Catherine, while she is being offered a ring by the Child Jesus (Figure 1). The overall composition, the body of the Christ Jesus and the hands of both adults are evocative of Mannerism.

Figure 1

Mystic Marriage of St. Catherine. Collection Hjalmar Linder. Photo: Finnish National Gallery (Copyright free).

From a dermatological point of view, St. Catherine displays a striking redness of the fingers, the nose and the ears that would be diagnosed nowadays as idiopathic acrocyanosis (Figure 2). Acrocyanosis is a permanent vascular acrosyndrome mainly observed in young, thin and tall women. Apart from the extremities, nose, ear and lips and nipples can be also affected. St. Catherine presents acrocyanosis on the nose, ears and fingers. She died at the age of 18 years old (287–305), and there is no information regarding a possible condition she may have presented during her childhood. Crespi might also had been inspired by some young lady from his entourage with acrocyanosis for the portrait of St. Catherine. We failed to find any other work of art in the medical literature, for which acrocyanosis has been identified. However, we cannot fully rule out a stylistic habit of Crespi. Acknowledging the well‐known limits of iconodiagnosis, this is the first identified representation of acrocyanosis in a work of art.

Figure 2

Close‐up view of the hands (Photo: Nicolas Kluger).

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