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Pt presented with this and no itching give diagnosis

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cherry angioma multiple scattered red papules trunk

Diagnosis: Cherry Angiomas (De Morgan Spots)

The images show multiple small, well-circumscribed, dome-shaped bright red to reddish-violaceous papules scattered across the trunk (lateral abdomen/flank), ranging from 1-5 mm in diameter. Surfaces are smooth and shiny with no scaling, crusting, or ulceration.
Key diagnostic features present:
  • Bright red/cherry-red color (due to dilated dermal capillaries)
  • Dome-shaped, smooth surface papules
  • Scattered distribution predominantly on the trunk
  • No itching (classic for cherry angiomas - they are asymptomatic)
  • Multiple lesions of varying sizes
  • No central punctum or keratotic plug
This is the classic presentation of Cherry Angiomas (also called Campbell de Morgan spots or senile angiomas).

What are Cherry Angiomas?

Cherry angiomas are benign proliferations of dilated post-capillary venules in the papillary dermis. They are the most common vascular proliferation of the skin.
  • Epidemiology: Appear from the 3rd decade onward; prevalence increases with age (up to 70-75% of adults over 70 years have them)
  • Pathology: Lobular capillary proliferation in the upper dermis with ectatic thin-walled vessels
  • Sites: Primarily trunk, then proximal limbs
  • Symptoms: Asymptomatic - no itching, no pain (as in this patient)
  • Color: Blanch on diascopy (pressure), distinguishing them from purpura

Differential Diagnoses to Consider

ConditionWhy it's less likely here
Pyogenic granulomaUsually solitary, bleeds easily, rapid onset
Spider angiomaCentral arteriole with radiating vessels; blanches from center
Kaposi sarcomaViolaceous plaques/nodules; dermatomal/linear distribution; immunocompromised patients
Petechiae/purpuraFlat, do not blanch, no raised papule
Molluscum contagiosumUmbilicated center with cheesy plug

Management

Cherry angiomas are entirely benign and require no treatment. Options for cosmetic removal if desired:
  • Electrodesiccation/electrocautery
  • Pulsed dye laser (PDL) - treatment of choice
  • Shave excision
  • Cryotherapy
No investigations needed unless lesions are atypical or rapidly multiplying (rarely, eruptive cherry angiomas can be a paraneoplastic sign).
Cherry angiomas - multiple scattered red papules on trunk
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