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, the pulsed dye laser is highly effective with only one treatment needed in the majority of cases. Electrocautery may be performed, but is more likely than laser treatment to result in a small scar or lead to recurrence.
For adults, the same treatment measures may be done after hepatic blood screening/workup is performed.
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