08-19-2018, 04:41 PM
Spider telangiectasia (nevus araneus): subcutaneous radial array of dilated (ectatic) small blood vessels (e.g., small arteries, arterioles, capillaries, venules, small veins) emanating from a central vascular core
- resembles a spider: central vascular core = spider body; radial array of dilated blood vessels = spider legs
- blanches when pressure is applied → re-appears when pressure is removed
Telangiectasias are associated with states of hyperestrogenism (e.g., cirrhosis, pregnancy).
Hereditary hemorrhagic telangiectasia (Osler Weber Rendu syndrome) is an autosomal dominant disease characterized by mucosal telangiectasias.
The mucosal telangiectasias in hereditary hemorrhagic telangiectasia are arteriovenous malformations.
Patients with hereditary hemorrhagic telangiectasia present with:
• Recurrent epistaxis
• GI bleeding
• Hematuria
• Cutaneous discolorations
Hemangioma is a benign vascular proliferation.
Juvenile (“strawberry”) hemangiomas are benign capillary tumors that are visible soon after birth. They rapidly increase in size and spontaneously regress during childhood. Treatment is usually not indicated for these tumors.
Cherry hemangiomas are benign capillary tumors seen in elderly patients. Cherry hemangioma do not regress and their frequency increases with age.
While strawberry hemangiomas appear in infancy and regress spontaneously, cherry hemangiomas become more frequent with age and do not regress.
Mnemonic: Strawberry fields NOT forever
Sturge-Weber syndrome presents with a nevus flammeus “birthmark” port-wine stain (congenital unilateral cavernous hemangioma) on the face in the CN V (usually V1 or V2) dermatomal distribution.
Some patients with Sturge-Weber syndrome have an ipsilateral arteriovenous malformation of pia mater vessels called an ipsilateral leptomeningeal angioma that overlies the occipital and parietal lobes.
Please refer to the Neurocutaneous Disorders (Phakomatoses) topic for more information on Sturge-Weber syndrome.
Bacillary angiomatosis is caused by Bartonella henselae infection, which causes cat scratch disease in immunocompetent individuals.
Benign capillary skin papules that is found in HIV and other immunocompromised patients.
The cutaneous lesions in patients with bacillary angiomatosis appear as vascular, often pedunculated masses. They are frequently mistaken for Kaposi sarcoma.
Pyogenic granuloma is a benign capillary proliferation that can ulcerate and bleed. It is associated with trauma and pregnancy.
The name is somewhat misleading as it is not a true granuloma. They are also not pyogenic, as they arise from a traumatic, not infectious process.
Cystic hygroma is a cavernous lymphangioma of the neck, commonly associated with Turner syndrome.
Glomus tumor is a benign, painful, red-blue tumor that commonly appears underneath the fingernails. It arises from glomus bodies, an arterio-venous shunt used to expel heat that is commonly found in the distal extremities. Patients present with episodic pain that can be triggered by cold temperatures.