spider angioma (nevus araneus, arterial spider)

Introduction

A red focal telangiectatic network of dilated capillaries radiating from a central arteriole.

Etiology

• liver disease
  • subacute & chronic viral hepatitis
  • alcoholic cirrhosis
• increased estrogen
  • pregnancy
  • estrogen therapy
• idiopathic

Epidemiology

• not uncommon in normal individuals, but up to 15% in normal elderly
• more common in females
• may occur in children (no medical significance)

Pathology

• central arteriole, slightly raised above skin surface (the spider body)
• blood flows out through radiating capillaries (the spider legs)

Clinical manifestations

• up to 1.5 cm in diameter
• generally solitary
• radiating telangiectasia blanch & central arteriole may pulsate
• most commonly occurs on the face, forearms & hands
• spider angiomas arising in childhood & during pregnancy may regress spontaneously

* images

Differential diagnosis

• hereditary hemorrhagic telangiectasia
• ataxia telangiectasia
• systemic scleroderma

Management

electrodesiccation or laser surgery

More general terms

• telengiectasia
• nevus
• sign/symptom