Spider Angioma (Nevus Araneus)

Spider Angioma (Nevus Araneus) is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Benign dilated arteriole with a characteristic spider-like appearance where the arteriole is close to the surface of the skin at a central point (spider body) and has radiating capillaries (spider legs)
  • Distribution is that of the superior vena cava. On adults, the face, neck, upper trunk, and arms are typically involved. In children, they are most often seen on the fingers and hands.
  • Tend to be permanent in adults, may fade in children and following pregnancy

Epidemiology

Occurs normally in adults and young children; is also associated with liver disease and pregnancy

Incidence
  • Present in 10–15% of normal adults and up to 40% of young children, although many of these fade
  • No predominant sex
  • No predominant race. However, lesions are easier to see in patients with lighter skin.
  • Pregnant women and children are most commonly affected (1).
    • Pregnancy considerations: occurs in 60–70% of pregnant white women and 10% of pregnant dark-skinned women (2)
    • More common in pregnant woman in their 1st and 2nd trimesters of pregnancy (2)
    • A reported 38% of school-aged children have 1 to 4 spider angiomas, with increased numbers of lesions with age.

Etiology and Pathophysiology

  • Spider angiomas are classified as primary (cause unknown) telangiectasias.
  • Probably stimulation via elevated estrogen concentrations as seen in pregnancy and liver disease
  • In liver disease, estrone, which derives from the androgen androstenedione, is elevated.

Risk Factors

  • Pregnancy: Lesions that arise with pregnancy may resolve within months of delivery.
  • Liver disease (cirrhosis)
  • Hormonal contraception use, cryosurgery, laser, or electrosurgery, and topical steroid use may predispose to formation of telangiectasias.

General Prevention

None

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