II. Epidemiology

  1. Common lesions in adults over age 40
  2. Increase in number with age

III. Pathophysiology

  1. Composed of dilated capillaries

IV. Causes

  1. Most cases are idiopathic associated with aging
  2. Chemical exposure
    1. Mustard Gas
    2. 2-Butoxyethanol
  3. Hormomal changes
    1. Pregnancy
    2. Increased Prolactin

V. Symptoms

  1. Asymptomatic
  2. Lesion may bleed significantly with local Trauma

VI. Signs

  1. Characteristics
    1. Benign soft, compressible dome-shaped Papule
    2. Small (< 6 mm diameter)
    3. Bright red (cherry red) or violet colored lesions
    4. Vascular and blanches with pressure
  2. Distribution
    1. Trunk
    2. Proximal extremities (especially arms)

VII. Differential Diagnosis

  1. Angiokeratoma
  2. Venous lake
  3. Pyogenic Granuloma
  4. Nodular amelanotic Melanoma
  5. Metastatic carcinoma (hypernephroma)

VIII. Management: Cosmetic removal (or if recurrent Trauma with bleeding)

  1. Laser coagulation (laser ablation)
  2. Electrocautery (electrodesiccation)
  3. Excision of larger lesions
  4. Cryotherapy is not effective

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