The spider angioma is a vascular lesion is common in children, pregnancy and in patients with liver disease. A small arteriole comes to the surface and spreads out in an arcade.
A central vascular point that feeds a circular vascular arcade is characteristic. Compressing the central point blanches the arcade. Two presentations are typical. The first is one or several lesions in a child. The most common site is just below the eye on the upper cheek although the back of the hands is common as well. This variant is common and unassociated with internal disease. The second is the onset of multiple lesions in an adult. The chest is most commonly affected. These cases are often associated with liver disease, e.g. LFT elevations, Hepatitis B, fatty liver.
For children, no treatment is needed and one usually can expect resolution sometime before adulthood. If treatment is needed, light electrocautery with an epilator needle to the central vascular point is successful in 80% of cases, although the feeding arteriole may find its way back to the arcade leading to a recurrence. When this happens, the central lesion is often slightly larger. The electrocautery is usually done without anesthesia. If needed, the pulsed dye laser is highly effective with only one treatment needed in the majority of cases.
For adults, similar treatment measures may be done after hepatic blood screening/workup is performed.
Just below the eye is a very common location.
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