SPOTTERS
MEDICINE
SPIDER NAEVI
🔹 Definition:
Spider
naevus (spider angioma) is a superficial vascular lesion consisting of a central
arteriole with radiating capillaries, resembling a spider. It blanches with
pressure and refills from the center outward.
🔹 Appearance:
- Central red papule with
fine radiating blood vessels
- Commonly seen on face, neck,
upper chest, and arms
- More prominent in fair-skinned
individuals
🔹 Pathophysiology:
- Caused by dilation of
cutaneous arterioles due to increased estrogen levels or vascular
fragility
- Seen in both physiological and
pathological conditions
🔹 Common Sites:
- Face (cheeks, nose)
- Neck
- Upper trunk and arms
🔹 Causes:
🔸 Physiological:
- Pregnancy (due to increased estrogen)
- Puberty
- Use of oral contraceptive
pills
🔸 Pathological:
- Chronic liver disease (e.g., cirrhosis)
- Seen in ~60–70% of patients
with alcoholic cirrhosis
- Thyrotoxicosis
- Severe malnutrition
🔹 Clinical Features:
- Asymptomatic
- Blanchable red lesion with central
punctum
- Refills from center on release
of pressure
- Multiple lesions may be seen in
systemic disease
🔹 Diagnostic Evaluation:
- Clinical diagnosis – based on typical appearance
and distribution
- Blanching test – diagnostic (central clearing
with pressure)
- In suspected liver disease:
- LFTs (AST, ALT, bilirubin)
- Prothrombin time, albumin
- Ultrasound abdomen
🔹 Differential Diagnosis:
- Telangiectasia
- Cherry angioma
- Hemangioma
- Capillary malformation
🔹 Treatment:
- None required for physiological spider naevi
- Treat underlying condition (e.g., liver disease, hormonal
imbalance)
- Cosmetic removal options:
- Laser therapy (pulsed dye
laser)
- Electrocautery
🔹 Prognosis:
- Regresses spontaneously in
pregnancy or after OCP withdrawal
- Persistent or multiple lesions
in adults suggest underlying liver disease and should be evaluated
DR.C.GANESAN
M.D.,
PROFESSOR OF
MEDICINE
No comments:
Post a Comment