A vascular lesion known as spider angioma, spider naevus, or spider telangiectasia is characterized by irregular dilation of end vasculature just beneath the skin's surface. A central red spot and reddish extensions radiate outward like a spider's web from the lesion. They may appear as a cluster of lesions or as a single lesion. A spider angioma has three parts: a body, legs, and erythema surrounding it.
As a punctum or eminence, the body appears as a 1 to 10 mm central arteriole. It's usually painless, looks like a spider's body, and is surrounded by attenuated capillaries that radiate in a spider-leg pattern, shrinking in size toward the edges.
Spider Angioma Disease
Spider Angiomas or Nevus Araneus; Spider Telangiectasia; Vascular Spider; Spider Nevus; Arterial Spiders are generally harmless, but they may be a sign of a systemic disease like Cirrhosis, Rheumatoid Arthritis, or Thyrotoxicosis. Solitary spider angiomas, which normally have less than three lesions, are seen in 15% of young adults. Other physiologic conditions, such as pregnancy or extreme malnutrition, can cause the lesions to appear. With a 95% sensitivity, multiple spider angiomas are indicative of chronic liver disease.
Spider angiomas are most common in people who have cirrhosis, alcoholic hepatitis, or hepatopulmonary syndrome. Spider nevi are associated with a higher risk of mortality in alcoholic liver disease patients. They may also indicate the presence of esophageal varices and the severity of hepatic fibrosis. Spider angiomas are found in 33 percent of people with cirrhosis.
According to one report, 38% of healthy kids had at least one spider telangiectasia. They can also be seen in about 60% of pregnant women. Physiological spider angiomas in younger adults normally go away as they get older, but in a few cases, it can take many years. When women take oral contraceptives and develop lesions, the lesions can disappear once the patient stops taking the hormonal preparations.
If spider angiomas are linked to pregnancy, they will go away after the baby is born. Spider angiomas have no ethnic preference, but lesions in light-skinned patients are more visible. The role of steroid hormones in the development of spider angiomas is thought to be why they are more common in women than in men.
Spider naevus is characterized by the dilation of preexisting central arterioles, from which several thin-walled capillary branches radiate like spider legs, bringing freely flowing blood away. They develop when the sphincteric muscle surrounding a cutaneous arteriole fails, causing the central arteriole to dilate. Spider angioma's exact cause is unknown. There have been numerous theories about the mechanisms that trigger arteriolar vasodilation for decades.
Direct vasodilatory effects of alcohol, substance P, hyperestrogenism, and insufficient hepatic metabolism of steroid hormones are all important. Due to elevated serum vascular growth factors such as vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) levels in patients with liver cirrhosis, angiogenesis has been suggested as a potential mechanism in the pathogenesis of spider nevi. The production of spider naevi has also been linked to a sex hormone imbalance, specifically hyperestrogenism. The presence of spider angioma in individuals in a hyperestrogenic condition, such as pregnancy, also supports this theory.
Treatment / Management of Spider Angioma
The cause of intra-arteriolar vasodilation determines how spider nevi are handled. Patients with an underlying systemic condition, such as cirrhosis, should receive routine treatment. When spider nevi are present, however, these patients may already be suffering from advanced liver disease.
Fine-needle electrocautery, 585 nm pulsed dye laser, 532 nm KTP (potassium-titanyl-phosphate) laser, or electro desiccation have all been used to remove spider angioma for cosmetic reasons on rare occasions. Except for the minor chance of scarring, the procedure's outcomes are usually positive. After treatment, spider angiomas can recur.
What are the symptoms of Spider Angiomas ?
The presence of the vessel cluster is the only symptom for most people with spider nevus. A red dot may appear in the middle of a cluster of thin vessels, but this isn't always the case. The thin vessels are red, blue, or purple in colour and form a web-like shape. Since blood is flowing back into the tubes, they will vanish and reappearance as you apply pressure.
Spider nevi may appear anywhere on the body, but the face, neck, and legs are the most common (sun-exposed areas). Aching or burning in the region of the vessel cluster can occur in some people. When the vessels are in the legs, and after a long period of standing, this pain is most common.
What causes spider angiomas ?
Anomalies include webs of tiny arterioles and capillaries that appear close to the skin.
It's unclear what causes this to happen. Spider nevi was thought to be caused by a variety of causes, according to researchers. These elements include:
- Exposure to sunlight
- Underlying diseases like liver disease
Spider nevi are a common sign of liver disease, particularly if there are many of them. Multiple vessel clusters are common in people with liver disease.
If you have a lot of oestrogen in your system, such as when you have chronic liver disease or when you're pregnant, spider nevus is normal. Spider nevus is more common in people who have Cirrhosis (liver disease) caused by alcohol than in people who do not have cirrhosis caused by alcohol.
How is Spider Nevus diagnosed?
Your doctor would almost certainly be able to tell whether you have spider nevi just by looking at the appearance of your skin. A skin biopsy may be needed to confirm the diagnosis in some cases. However, diagnosing the underlying cause and ruling out any factors that may have caused the vessel clusters is more critical.
You'll be asked about any hormone supplements you're taking, as well as any other drugs you're on. Since alcohol misuse can lead to liver disease, your doctor will also inquire about your alcohol intake. Spider nevi may indicate liver disease. If your doctor suspects you have a liver problem, he or she can take a blood sample to test.
The liver is responsible for a variety of important functions, including blood detoxification, food digestion, and the production of proteins that aid in blood clotting. Blood samples are taken to test for the enzymes and proteins released and excreted by the liver during liver disease examination, also known as a liver panel. The existence of certain forms of these substances, as well as increased or decreased levels of these substances, may indicate liver disease.
How can Spider nevus be prevented?
It's possible that you won't be able to completely avoid spider nevus. If you're predisposed to spider nevi due to family background or genetics, you'll get them regardless of what you do. Although there are no clear preventative measures known, you can help prevent new spider nevi from developing by doing the following:
- Avoiding hormone replacement therapy
- Applying sunscreen to the areas of the body that are most frequently affected, such as the face, neck, and legs
- Restricting your alcohol intake
- If liver disease is present, it must be treated.
Spider angiomas on the face are most common in fair-skinned people, but they can also happen in infants. There is no clear cause in most cases, but people with cirrhosis, as well as those pregnant or using oral contraceptives, also experience many spider angiomas. Angiomas in the form of spiders are not present at birth.
Spider angiomas are usually less than 14 inches (0.5 centimetres) in diameter. They are non-toxic and cause no effects, but they can be unsightly. Spider angiomas that occur during pregnancy or when using oral contraceptives normally go away on their own 6 to 9 months after the baby is born or the oral contraceptive is stopped.
Treatment for spider angiomas is not normally necessary, but if it is needed for aesthetic purposes, a doctor may use laser therapy or an electric needle to destroy the central blood vessel (electrodesiccation).