Spider angioma
Encyclopedia
A spider angioma is a type of telangiectasis 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. However, greater than five spider naevi may be a sign of liver disease
.
, neck
, upper part of the trunk
and arm
s. They may also be present on the backs of the hand
s and finger
s in young children.
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. People who have significant hepatic disease also show many spider angiomas, as their liver cannot detoxify estrogen
from the blood, resulting in high levels of estrogen. About 33% of patients with cirrhosis
have spider angiomas. As such, microhemorrhages may be observed as spider angiomas.
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.
For spider angiomas on the face, techniques such as electrodesiccation and laser treatment can be used to remove the lesion. There is a small risk of a scar
, although the results are generally good. Spider angiomas can recur after treatment.
If the centre of the angioma is pricked with a hypodermic needle, opening the dilated arteriole, blood will flow freely for some time unless pressure is applied; the arteriole will then shrink or coagulate and the angioma will disappear. This treatment is minimally painful and leaves no scar.
Benign
A benign tumor is a tumor that lacks the ability to metastasize. Common examples of benign tumors include moles and uterine fibroids.The term "benign" implies a mild and nonprogressive disease. Indeed, many kinds of benign tumors are harmless to human health...
, presenting in around 10-15% of healthy adults and young children. However, greater than five spider naevi may be a sign of liver disease
Liver disease
Liver disease is a broad term describing any single number of diseases affecting the liver.-Diseases:* Hepatitis, inflammation of the liver, caused mainly by various viruses but also by some poisons , autoimmunity or hereditary conditions...
.
Distribution
Spider angiomas are found only in the distribution of the superior vena cava, and are thus commonly found on the faceFace
The face is a central sense organ complex, for those animals that have one, normally on the ventral surface of the head, and can, depending on the definition in the human case, include the hair, forehead, eyebrow, eyelashes, eyes, nose, ears, cheeks, mouth, lips, philtrum, temple, teeth, skin, and...
, neck
Neck
The neck is the part of the body, on many terrestrial or secondarily aquatic vertebrates, that distinguishes the head from the torso or trunk. The adjective signifying "of the neck" is cervical .-Boner anatomy: The cervical spine:The cervical portion of the human spine comprises seven boney...
, upper part of the trunk
Torso
Trunk or torso is an anatomical term for the central part of the many animal bodies from which extend the neck and limbs. The trunk includes the thorax and abdomen.-Major organs:...
and arm
Arm
In human anatomy, the arm is the part of the upper limb between the shoulder and the elbow joints. In other animals, the term arm can also be used for analogous structures, such as one of the paired forelimbs of a four-legged animal or the arms of cephalopods...
s. They may also be present on the backs of the hand
Hand
A hand is a prehensile, multi-fingered extremity located at the end of an arm or forelimb of primates such as humans, chimpanzees, monkeys, and lemurs...
s and finger
Finger
A finger is a limb of the human body and a type of digit, an organ of manipulation and sensation found in the hands of humans and other primates....
s in young children.
Cause
Spider angiomas are 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 veins carrying away the freely-flowing blood. If momentary pressure is applied, it is possible to see the emptied veins refilling from the centre. No other angiomas show this phenomenon.The dilation, in turn, is caused by increased estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...
levels in the blood. Many pregnant
Pregnancy
Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...
women, or women using hormonal contraception
Hormonal contraception
Hormonal contraception refers to birth control methods that act on the endocrine system. Almost all methods are composed of steroid hormones, although in India one selective estrogen receptor modulator is marketed as a contraceptive. The original hormonal method—the combined oral contraceptive...
, have spider angiomas, due to high estrogen levels in their blood. People who have significant hepatic disease also show many spider angiomas, as their liver cannot detoxify estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...
from the blood, resulting in high levels of estrogen. About 33% of patients with cirrhosis
Cirrhosis
Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrosis, scar tissue and regenerative nodules , leading to loss of liver function...
have spider angiomas. As such, microhemorrhages may be observed as spider angiomas.
Treatment
Spider angiomas are asymptomaticAsymptomatic
In medicine, a disease is considered asymptomatic if a patient is a carrier for a disease or infection but experiences no symptoms. A condition might be asymptomatic if it fails to show the noticeable symptoms with which it is usually associated. Asymptomatic infections are also called subclinical...
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
Liver transplantation
Liver transplantation or hepatic transplantation is the replacement of a diseased liver with a healthy liver allograft. The most commonly used technique is orthotopic transplantation, in which the native liver is removed and replaced by the donor organ in the same anatomic location as the original...
is performed.
For spider angiomas on the face, techniques such as electrodesiccation and laser treatment can be used to remove the lesion. There is a small risk of a scar
Scar
Scars are areas of fibrous tissue that replace normal skin after injury. A scar results from the biological process of wound repair in the skin and other tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions, every wound results in...
, although the results are generally good. Spider angiomas can recur after treatment.
If the centre of the angioma is pricked with a hypodermic needle, opening the dilated arteriole, blood will flow freely for some time unless pressure is applied; the arteriole will then shrink or coagulate and the angioma will disappear. This treatment is minimally painful and leaves no scar.