Spider angioma
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spider angioma liver disease clinical features professional reference
Spider angioma (more accurately called spider telangiectasia, spider naevus, or nevus araneus) is a benign superficial dilatation of small blood vessels.
- Appearance: central bright-red papule or arteriole, with fine red vessels radiating outward like spider legs.
- Test: pressing the central point makes the whole lesion blanch; releasing pressure causes it to refill from the center outward.
- Common sites: face, neck, upper chest, and arms.
- Usually painless and often occurs as a single lesion in healthy children and adults.
Why it occurs
- May be idiopathic
- Pregnancy or estrogen exposure, including combined oral contraceptives
- Chronic liver disease, particularly cirrhosis
- Thyrotoxicosis
A single lesion is commonly harmless. Multiple, new, or enlarging lesions, especially with jaundice, abdominal swelling, easy bruising, fatigue, weight loss, palmar redness, or heavy alcohol use, merit medical assessment for possible liver or hormonal disease. More numerous/larger lesions can correlate with more severe liver disease. DermNet’s clinical reference and Andrews' Diseases of the Skin, section “Dilation of Preexisting Vessels,” describe the characteristic central arteriole and radiating vessels.
Treatment: none is needed unless cosmetically bothersome or due to an underlying condition. The cause should be addressed when present. Dermatologists can remove persistent lesions with vascular laser therapy or electrocautery, though recurrence can occur.
Recent PubMed systematic-review results did not identify a relevant modern review specifically about spider angiomas; the search mainly returned studies of spider bites, which are unrelated.
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