A spider angioma or spider naevus (plural spider naevi) is a type of telangiectasis[2] (swollen blood vessels) found slightly beneath the skin surface, often containing a central red spot and reddish extensions which radiate outwards like a spider's web. They are common and may be benign, presenting in around 10–15% of healthy adults and young children.[3] However, having more than three spider angiomas is likely to be abnormal and may be a sign of liver disease. It also suggests the probability of esophageal varices.[4]
Contents
1Signs and symptoms
2Cause
3Diagnosis
4Treatment
5See also
6References
7External links
Signs and symptoms
Spider nevus. In the center of the red lesion a small (1 mm) red papule is visible, surrounded by several distinct radiating vessels. Pressure on the lesion causes it to disappear. Blanching is replaced by rapid refill from the central arteriole when pressure is released.[5]
Multiple spider angiomata
Spider angiomas are found only in the distribution of the superior vena cava, and are thus commonly found on the face, neck, upper part of the trunk, and arms. They may also be present on the backs of the hands and fingers in young children.[citation needed]
Cause
Spider angiomas form due to failure of the sphincteric muscle surrounding a cutaneous arteriole. The central red dot is the dilated arteriole and the red "spider legs" are small capillaries carrying away the freely flowing blood. If momentary pressure is applied, it is possible to see the emptied capillaries refilling from the center. No other angiomas show this phenomenon.[6]
The dilation, in turn, is caused by increased estrogen levels in the blood. Many pregnant women, or women using hormonal contraception, have spider angiomas, due to high estrogen levels in their blood. Individuals with significant liver disease also show many spider angiomas, as their liver cannot metabolize circulating estrogens, specifically estrone, which derives from the androgen androstenedione.[3] About 33% of patients with cirrhosis have spider angiomas.[7] As such, microhemorrhages may be observed as spider angiomas.[citation needed]
Diagnosis
Diagnosis is by clinical examination. Spider naevi are most commonly seen by general practitioners, or dermatologists.
Whilst a lesion can be identified as a spider naevus, this is not a diagnosis in itself. The clinical picture should be indicative of whether there is underlying disease that should be investigated.
Treatment
Spider angiomas are asymptomatic and usually resolve spontaneously. This is common in the case of children, although they may take several years to disappear. If the spider angiomas are associated with pregnancy, they may resolve after childbirth. In women taking oral contraceptives, they may resolve after stopping these contraceptives. The spider angiomas associated with liver disease may resolve when liver function increases or when a liver transplant is performed.[citation needed]
For spider angiomas on the face, techniques such as electrodesiccation and laser treatment can be used to remove the lesion.[8] There is a small risk of a scar, however it usually leaves nothing. Spider angiomas can recur after treatment.
See also
List of cutaneous conditions
References
^Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. pp. 1621–22. ISBN 1-4160-2999-0.
^"spider angioma" at Dorland's Medical Dictionary
^ abNevus Araneus at eMedicine
^Udell, Jacob A.; Wang, Charlie S.; Tinmouth, Jill; FitzGerald, J. Mark; Ayas, Najib T.; Simel, David L.; Schulzer, Michael; Mak, Edwin; Yoshida, Eric M. (22 February 2012). "Does This Patient With Liver Disease Have Cirrhosis?". JAMA. 307 (8): 832–842. doi:10.1001/jama.2012.186. Retrieved 11 April 2018 – via jama.jamanetwork.com.
^Sand, M; Sand, D; Thrandorf, C; Paech, V; Altmeyer, P; Bechara, FG (4 June 2010). "Cutaneous lesions of the nose". Head & face medicine. 6: 7. doi:10.1186/1746-160X-6-7. PMC 2903548. PMID 20525327.
^McCluskey D R Journal of the Royal College of Physicians of Edinburgh 2004, 34: 104 - 105
^Li CP, Lee FY, Hwang SJ, et al. (1999). "Spider angiomas in patients with liver cirrhosis: role of alcoholism and impaired liver function". Scand. J. Gastroenterol. 34 (5): 520–3. doi:10.1080/003655299750026272. PMID 10423070.
^Geronemus, R. G. (1991). "Treatment of spider telangiectases in children using the flashlamp-pumped pulsed dye laser". Pediatr Dermatol. 8 (1): 61–3. doi:10.1111/j.1525-1470.1991.tb00843.x. PMID 1862028.
…pathogenesis of spider angiomata is incompletely understood, but they are believed to result from alterations in sex hormone metabolism. One study suggested that the presence of spider angiomata in men was …
…of the underlying bone (Klippel-Trenaunay syndrome) . The spider nevus, the best-known type of telangiectasia (also known as spider angioma, vascular spider, or nevus aranei), is a central vascular papule …
…or through the skin, and usually regress postpartum. Vascular spiders (spider angiomas, nevi aranei, arterial spiders, spider nevi) develop in 66 percent of Caucasians and 11 percent of blacks . They appear …
…can be treated with electrodesiccation alone, including skin tags and angiomas (eg, cherry and spider angiomas). As noted above, the author prefers to treat both seborrheic keratoses and sebaceous hyperplasia…
…dysfunction. Spider nevi (also referred to as spider angiomas) in a patient with chronic liver disease or portal hypertension should raise the suspicion for the presence of possible HPS Spider nevi are cutaneous …
English Journal
Multi-wavelength laser treatments of spider nevi.
Yang J, An X, Li Y, Tao J.
Lasers in medical science. 2019 Jun;34(4)737-742.
Spider nevi (SN) are one of common vascular diseases. Different treatment techniques have been described for SN previously, including electrocoagulation, argon laser, pulsed dye lasers (PDL), pulsed potassium titanylphosphate laser (KTP), and 1064-nm neodymium yttrium-aluminum-garnet (Nd:YAG) laser.
Impact of spider nevus and subcutaneous collateral vessel of chest/abdominal wall on outcomes of liver cirrhosis.
Li H, Wang R, Méndez-Sánchez N, Peng Y, Guo X, Qi X.
Archives of medical science : AMS. 2019 Mar;15(2)434-448.
Spider nevus and subcutaneous collateral vessel of the chest/abdominal wall are common in liver cirrhosis. This prospective study aimed to evaluate the impact of spider nevus and subcutaneous collateral vessel of the chest/abdominal wall on the outcomes of cirrhotic patients. We prospectively enroll
Spider nevus goes by several names: spider veins spider angioma nevus araneus vascular spider A spider nevus is a collection of small, dilated arterioles (blood vessels) clustered very close to the surface of the skin. The ...
Nevus araneus, also known as spider angioma or spider nevus, is a common benign vascular lesion present in 10-15% of healthy adults and young children. They may appear as a solitary or multiple lesions.
Spider Naevus is also sometimes called arterial spider, vascular spider. There are also other names for Spider Naevus, learn more about Spider naevus here ... Presentation Spider naevi are usually asymptomatic.