SYMPTOMS

What are spider angiomas?

Spider angiomas (also known as spider telangiectasias) are vascular lesions consisting of a central arteriole surrounded by numerous smaller radiating vessels.

They most commonly appear on the trunk, face, and upper extremities. When pressure is applied with a glass slide to the central arteriole, pulsation can be observed. After brief ischemia causes sudden blanching, blood first refills the central arteriole before flowing into the fine branching tips of each "leg."

Multiple radiating "legs" with surrounding erythema are typical, which may encircle the entire lesion or just its central arteriole. The center of the lesion features a raised central point extending capillary branches outward, resembling a red spider on the skin—hence the name "spider angioma."

Typical presentation of spider angioma (Image source: Zcool)

How do spider angiomas develop?

The exact pathogenesis remains unclear, but current evidence suggests they result from altered sex hormone metabolism. One study found that spider angiomas in males correlate with an elevated estradiol/free testosterone ratio.

Which conditions are associated with acquired spider angiomas?

Acquired spider angiomas are not pathognomonic for cirrhosis, as they also occur in pregnant women and severely malnourished patients. Healthy individuals may develop fewer than three small lesions.

Generally, the number and size of spider angiomas correlate with liver disease severity. Patients with numerous large lesions may have increased risk of variceal bleeding.

TREATMENT

How to Alleviate or Eliminate Spider Angiomas?

• When spider angiomas appear, the first step is to seek medical attention promptly to determine the cause, rather than attempting to alleviate them blindly.

• For spider angiomas caused by liver disease or other related conditions, the primary disease should be actively treated.

• For adolescent girls and pregnant women, spider angiomas are a normal occurrence and will typically fade on their own within two months after childbirth for pregnant women.

• Spider angiomas generally do not cause significant discomfort. However, for those located on the face or neck that severely affect appearance, laser therapy or surgical treatment may be considered.

DIAGNOSIS

When should you seek medical attention for spider angiomas?

Spider angiomas are most commonly seen in patients with liver diseases such as cirrhosis and acute hepatitis. Therefore, if spider angiomas are detected, immediate medical consultation is necessary to determine the underlying cause. Particular attention should be paid if accompanied by the following symptoms:

• General weakness, fatigue, or swelling;

• Yellowing of the skin or whites of the eyes (jaundice);

• Loss of appetite, aversion to greasy foods, nausea, vomiting, or bloating;

• Easy bruising, nosebleeds, or purpura;

• Decreased urine output, black stools, or vomiting blood.

POTENTIAL DISEASES

What are the possible causes of spider angiomas?

• Liver diseases such as cirrhosis, acute hepatitis, chronic hepatitis, and liver cancer;

• Rheumatic diseases, rheumatoid arthritis, Cushing's syndrome, etc.;

• Vitamin B deficiency, xeroderma pigmentosum, chronic radiation dermatitis, lupus erythematosus, hemochromatosis, Raynaud's disease, severe malnutrition;

• After local trauma;

• Adolescent girls and pregnant women.