Spiders on the skin: Spider angioma

Abstract

Spider angiomas are cutaneous manifestations usually described with liver disease. They result from dilatation of an arteriole with multiple radiating vessels emerging from it. Pressure on the central arteriole can make the entire lesion disappear which reappears once it is released. The lesions are typically seen in the territory of superior vena cava. The number of lesions varies but more than a couple must prompt concern about underlying liver disease. Histologically, it consists of central arteriole with radial branching of telangiectasia in the periphery. Different theories have advocated increased levels of vascular endothelial growth factor, basic fibroblast growth factor, estrogen/testosterone ratio and substance P as reason for their development. Usually they remain asymptomatic in a majority of subjects and do not need therapy. If treatment is needed for cosmetic purposes, it may include electrocoagulation or laser. These lesions may disappear with improvement in underlying hepatic disease or after liver transplantation.

Keywords: spider angioma; cirrhosis; alcoholic liver disease; viral hepatitis; liver

Received: April 3, 2012; Accepted: April 13, 2012; Published online: May 3, 2012

Corresponding Author: Vishal Sharma, 1819, Gobind Nagar, Subhash Road, Chheharta, Amritsar, Punjab, India. E-mail: docvishalsharma@gmail.com