What is Spider Angioma?
A spider angioma, also known as a spider naevus or a spider telangiectasia, is a type of skin condition. This condition happens when tiny blood vessels under the surface of the skin get bigger in an unusual way. The affected spot has a red center with red lines coming out from it, making it look like a spider’s web. Spider angiomas can show up as a single spot or multiple spots.
There are three parts to a spider angioma: a body, legs, and a reddish area around it, known as erythema. The body, which looks like a spider’s body, is a small spot or bump, about 1 to 10 millimeters across, which can be seen on an artery called an arteriole. This arteriole is surrounded by very thin, branch-like blood vessels – these are the legs of the “spider”. The blood vessels get smaller towards the edge. Spider angiomas are usually not painful. Understanding their features can be very helpful in identifying and treating these skin conditions correctly.
What Causes Spider Angioma?
Spider angiomas are generally non-harmful, but they can sometimes hint at more serious health issues like cirrhosis (a liver disease), rheumatoid arthritis (an autoimmune disease that affects the joints), or thyrotoxicosis (overactive thyroid).
Single spider angiomas show up in about 15% of young adults, usually having less than 3 lesions or spots. These spots can also appear in other conditions like pregnancy or severe undernourishment. If several spider angiomas are seen, this is typically indicative of chronic liver disease, with a 95% accuracy rate.
Risk Factors and Frequency for Spider Angioma
Spider angiomas, sometimes known as spider nevi, are most commonly seen in patients who have cirrhosis, alcoholic hepatitis, or hepatopulmonary syndrome. If someone with alcoholic liver disease has these spider angiomas, it suggests a higher risk of death. They also indicate a strong chance of esophageal varices and give a sense of the severity of liver scarring, or hepatic fibrosis.
Studies have shown that 33% of people with cirrhosis have spider angiomas. When it comes to healthy children, about 38% will have at least one of these angiomas. Pregnant women often develop them, with around 60% showing them. People who are younger tend to see these angiomas fade as they age, although for some people, they stick around for several years.
In cases where women on oral contraceptives develop these angiomas, stopping the contraceptives often results in the angiomas disappearing. Similarly, for pregnant women, they often disappear after the baby is born. There are no racial groups more prone to spider angiomas. Still, they tend to be more visible in patients with lighter skin. Additionally, spider angiomas are more common in women than men, which may be due to the effect of steroid hormones.
- Spider angiomas are seen most commonly with cirrhosis, alcoholic hepatitis, and hepatopulmonary syndrome.
- Those with alcoholic liver disease having spider angiomas indicate a higher risk of death.
- They suggest a high chance of esophageal varices and help determine the extent of liver scarring.
- 33% of cirrhosis patients and 38% of healthy children have spider angiomas.
- About 60% of pregnant women will develop spider angiomas.
- Younger people often see these angiomas disappear with age, although in some cases, it may take several years.
- Women on birth control who develop these angiomas often see them disappear after stopping the contraceptive.
- Pregnant women tend to see a decrease in their spider angiomas after giving birth.
- No particular racial group is more likely to develop spider angiomas.
- They are more visible among people with lighter skin.
- Spider angiomas are more common in women, possibly due to the influence of steroid hormones.
Signs and Symptoms of Spider Angioma
Spider angiomas are small, spider-like skin blemishes that are commonly found on the face, neck, upper chest, and arms in adults. In children, it’s not uncommon to find these skin changes on the upper extremities, and also possibly on the backs of hands and fingers. These are not strictly limited to the skin, and can also develop on the mucous membranes inside the mouth or the gastrointestinal tract. They tend to have a distinctive spider-like appearance, and the larger examples may exhibit visible pulsing. Despite their prominent appearance, they don’t normally bleed unless they are accidentally damaged, and the skin around a spider angioma is often warmer than the rest of the skin.
This is because the arterioles, or small arteries, that supply these skin changes have higher blood pressure than usual, between 50 to 70 mm Hg. The flow of blood in a spider angioma can be observed by pressing on it with a glass slide. After pressure is released, the skin will regain its normal color. This particular effect can be seen in spider angiomas, but not in other similar skin changes. These angiomas can vary in size and are therefore categorised into grades 1 through 4, depending on their visibility and other features such as whether they are pulsating or raised.
Pregnant women often develop many spider nevi, another term for spider angiomas, but these disappear on their own after the baby is born. In patients with chronic liver disease, these spider angiomas are a common symptom, but these patients usually present other symptoms as well, such as jaundice, water retention, disturbed mental functioning, and other signs related to the cause of their liver disease.
Testing for Spider Angioma
If you’re healthy or pregnant and have a single spider nevus (a type of skin condition), you usually don’t need to have additional testing. A detailed background review and physical check-up can often link multiple spider angiomas (another type of skin condition) back to liver disease. In most cases, the more spider angiomas someone has, and the bigger they are, the more severe their liver disease is likely to be.
Sometimes, your medical history and physical exam may not clearly indicate spider angiomas, leading to worry about skin cancer, like basal cell carcinoma (a common type of skin cancer). In these cases, a skin biopsy (a test where a small piece of skin is removed and examined) can be helpful to rule out skin cancer or other conditions.
Treatment Options for Spider Angioma
The treatment for spider nevi, which are small, spider-like blood vessels visible under the skin, depends on what is causing them. If they are due to a larger health issue like cirrhosis (a type of liver disease), the patient should be treated following standard guidelines for that disease. However, when spider nevi appear, it can be a sign that a patient’s liver disease has become quite serious.
In cases where the spider nevi are a cosmetic concern, there are some options for treatment. These includes fine-needle electrocautery, a procedure using a heated needle to destroy the veins, a 585 nm pulsed dye laser, a type of laser treatment, a 532 nm KTP laser, another kind of laser therapy, or electro desiccation, a method which uses electrical current to dry out and destroy the unwanted tissue. While these treatments generally work well, there is a small risk of scarring. It’s also worth noting that the spider nevi can return after treatment.
In healthy individuals who aren’t dealing with an underlying health issue, spider nevi usually go away on their own after a few years. For women who develop them during pregnancy, they typically disappear after childbirth. If they are related to the use of birth control pills, they generally go away after the medication is discontinued. And for patients suffering from cirrhosis, spider nevi often vanish after a successful liver transplant.
What else can Spider Angioma be?
- Acneiform Eruptions
- Basal Cell Carcinoma
- Cherry Hemangioma
- Coastal Fringe
- Essential telangiectasia
- Fabry disease
- Hereditary hemorrhagic telangiectasia
- Insect Bites
- Lobular capillary hemangioma
- Osler-Weber-Rendu Syndrome
- Rosacea
- Scleroderma
- Unilateral Nevoid Telangiectasia
