II. Definitions

  1. Telangiectasia (Spider Vein)
    1. Permanent dilation of small blood vessels (capillaries) near the skin surface or on the mucous membranes
    2. Lesions may appear on the Tongue, lips and Palate, Conjunctiva, nail beds or involve any skin surface
    3. Frequently located on the lower legs

III. Pathophysiology

  1. Venous reflux from underlying Varicose Veins

IV. Causes: General

  1. Inherited (Genetic Syndromes)
    1. Ataxia Telangiectasia or related conditions (e.g. Bloom Syndrome)
    2. Hereditary Hemorrhagic Telangiectasia (Osler-Weber-Rendu Syndrome)
    3. Numerous other more rare genetic disorders with Telangiectasias exist
    4. Generalized essential Telangiectasia
      1. Uncommon cause of widespread Telangiectasia (esp. on legs), typically in adult women
  2. Acquired
    1. Rosacea
    2. Cirrhosis (e.g. Caput Medusa)
    3. Cushing Syndrome
    4. Pregnancy
    5. Scleroderma (Systemic Sclerosis)
    6. Chronic Cutaneous Lupus (CCLE, Discoid Lupus)
    7. Necrobiosis Lipoidica
    8. Carcinoid Syndrome
    9. Dermatomyositis
  3. Trauma
    1. Sun Damaged Skin
    2. Hypertrophic Scar
  4. Malignancy
    1. Basal Cell Carcinoma
    2. Kaposi Sarcoma
    3. Merkel Cell Carcinoma
    4. Lymphoma (e.g. Cutaneous T-Cell Lymphoma, Invasive B Cell Lymphoma)
  5. Medications
    1. Calcium Channel Blockers (and other vasodilating medications)
      1. Sun-exposed areas
    2. Corticosteroids
      1. Associated with longterm use of either topical or Systemic Corticosteroids
      2. May also occur with intralesional Corticosteroid Injection

V. Evaluation: Localized Telangiectasias

  1. Papular Telangiectasia
    1. Cherry Angioma
    2. Angiokeratoma
    3. Basal Cell Carcinoma
    4. Angiofibroma
  2. Macular Telangiectasia as Primary Lesions
    1. Skin Atrophy
      1. Broca's Telangiactasias
      2. Purpura Annularis Telangiectodes of Majocchi (Majocchi's disease)
    2. Absent Skin Atrophy
      1. High Estrogen State (e.g. Pregnancy)
        1. SpiderNevi
        2. Unilateral Nevoid Telangiectasia
      2. Elderly
        1. Costal Fringe
          1. Band of Telangiectasias along the anterolateral costal margins
      3. Child and Teen
        1. Upper half of body
          1. Capillary malformation (e.g. Port-Wine Stain, Nevus Simplex)
        2. Lower half of body
          1. Angioma Serpiginosum
      4. HIV
        1. HIV-Related Telangiectasia
  3. Macular Telangiectasia as Secondary Lesions (associated with broader skin or systemic disorder)
    1. Skin Atrophy
      1. Sun Damaged Skin (Poikiloderma of Civatte)
      2. Longterm Topical Corticosteroid-related skin damage
      3. Radiation Therapy Induced Skin Changes
      4. Scleroderma
      5. Discoid Lupus (Telangiectoid Variant)
      6. Cutaneous T-Cell Lymphoma (Poikiloderma Atrophicans Vasculare)
      7. Angiolupoid Sarcoidosis
    2. Absent Skin Atrophy
      1. Rosacea
      2. Mastocytosis
      3. Seborrheic Dermatitis
      4. Hereditary Hemorrhagic Telangiectasia

VI. Imaging

  1. Venous Doppler Ultrasound
    1. Consider when venous reflux is suspected

VII. Management

  1. Radiofrequency Surgery (Electrosurgery)
    1. Coagulation or Electrodesiccation of involved superficial vessels
  2. Laser Photorejuvenation
  3. Intense Pulse Light Therapy
  4. Sclerotherapy

VIII. Resources

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Telangiectasis (C0039446)

Definition (CHV) a visibly dilated blood vessel on the skin
Definition (CHV) a visibly dilated blood vessel on the skin
Definition (CHV) a visibly dilated blood vessel on the skin
Definition (CHV) a visibly dilated blood vessel on the skin
Definition (NCI_NCI-GLOSS) The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes.
Definition (NCI_CTCAE) A disorder characterized by local dilatation of small vessels resulting in red discoloration of the skin or mucous membranes.
Definition (NCI) Local dilatation of small vessels resulting in red discoloration of the skin or mucous membranes.
Definition (CSP) localized convolution and dilatation of a group of small blood vessels, leading to hemorrhage and angioma.
Definition (MSH) Permanent dilation of preexisting blood vessels (CAPILLARIES; ARTERIOLES; VENULES) creating small focal red lesions, most commonly in the skin or mucous membranes. It is characterized by the prominence of skin blood vessels, such as vascular spiders.
Concepts Disease or Syndrome (T047)
MSH D013684
SnomedCT 276328002, 155449008, 266324004, 112641009, 247479008
English Telangiectasia, TELANGIECTASIA, TELANGIECTASIS, Telangiectases, telangiectasia, telangiectasia (physical finding), Telangiectasis [Disease/Finding], telangiectases, telangiectasias, telangiectasis, Telangiectasias, Telangiectasia (disorder), peripheral vascular disease telangiectasia, Telangiectasia disorder (diagnosis), Telangiectasia disorder, Telangiectasia disorder (disorder), Telangiectasis (morphologic abnormality), Telangiectasia, NOS, Telangiectasis, NOS, Telangiectasis
French TELANGIECTASIE, Télangiectasies, Télangiectasie
Portuguese TELANGIECTASIA, Aranha Vascular, Telangiectasia Aracniforme, Telangiectasia em Aranha, Telangiectasia
Spanish TELANGIECTASIA, Telangiectasis, telangiectasia (trastorno), enfermedad telangiectásica (trastorno), enfermedad telangiectásica, telangiectasia (anomalía morfológica), telangiectasia, Telangiectasia
German TELEANGIEKTASIE, Teleangiektasie
Italian Telangiectasia, Telangectasia
Dutch teleangiectasis, teleangiëctasieën, Aderen, spat-, Spatader, Angiëctasie, tele-, Teleangiëctasie
Swedish Telangiektasi
Japanese モウサイケッカンカクチョウショウ, 末梢血管拡張, 毛細血管拡張症, 毛細血管拡張, 末梢血管拡張症
Czech teleangiektazie, Telengiektázie, Teleangiektázie
Finnish Teleangiektasia
Polish Teleangiektazja, Poszerzone naczynia włosowate
Hungarian Teleangiectasia, Telangiectasia
Norwegian Telangiektasi

Ontology: Spider Veins (C1138421)

Concepts Anatomical Abnormality (T190)
MSH D013684
French Télangiectasie rouge en araignée, Angiomes stellaires, Capillarectasie diffuse, Angiomes arachnéens
Italian Vena a ragnatela, Capillari a ragnatela, Vene a ragnatela, Vene a ragno
Japanese くも状静脈, クモジョウジョウミャク, くも状バースト, クモジョウバースト
Portuguese Veias Arâneas, Angioma aracnídeo, Veia aracniforme
Spanish Venas Telarañas, Arañas venosas, Venas aracniformes
German Spider-Venen, Besenreiservarizen
Czech Pavoučková véna, Pavoučková žíla
English Spider-burst, spider vein, spider veins, vein spider, Veins, spider, Spider Vein, Vein, Spider, Veins, Spider, Spider vein, Spider Veins
Dutch spider-burst, verwijd haarvat, Spataderen
Hungarian Pók vena, Pókszerű szakadás
Norwegian Spidernævus, Spidernevi, Spider-vene