Presentation
There are only few case reports of large spider nevi reported in the literature. [1], [2], [7] The present case is unique because of its very large size, rare presentation over the forehead and palpable mass like vascular lesion in a patient with nonalcoholic [ijabmr.org]
Report of a Case.— The patient, a 34-year-old male coal miner, presented in May 1988 complaining of visual disturbances, fatigue, and night sweats of 6 months' duration. [jamanetwork.com]
[…] multiple lesions are present, liver disease, estrogen therapy, and thyrotoxicosis should be considered. [emedicine.medscape.com]
They are common and may be benign, presenting in around 10-15% of healthy adults and young children. However, having more than five spider naevi may be a sign of liver disease. [alrustom-laser.com]
They are common and may be benign, presenting in around 10-15% of healthy adults... (40 of 854 words, 1 image) en.wikipedia.org/wiki/Spider angioma Oxford Dictionary: spider naevus a cluster of minute red blood vessels visible under the skin, occurring [memidex.com]
Entire Body System
- Asymptomatic
The lesions are asymptomatic and usually resolve spontaneously about 6 to 9 months postpartum or after oral contraceptives are stopped. Lesions are not uncommon on the faces of children. [msdmanuals.com]
Spider naevi are usually asymptomatic. Presentation is either due to possible concern about the aetiology or, especially if they are on the face, because of cosmetic effect. Rarely, they may bleed with minor trauma. [skinqure.co.uk]
Although generally asymptomatic spider naevi may be a sign of an underlying medical condition such as cirrhosis of the liver, however they can also appear in healthy people, especially pregnant women, and even as a side effect of medication. [lasermelbourne.com.au]
Spider angiomas are asymptomatic and some resolve spontaneously. This is common in the case of children, although they may take several years to disappear. If the spider angiomas are associated with pregnancy, they may resolve after childbirth. [alrustom-laser.com]
- Pallor
Physical examination revealed pallor, icterus, pedal edema, hepatospleenomegaly and tense ascites. She had multiple classical spider nevi over the chest. [ijabmr.org]
The direction of blood flow can be illustrated by applying pressure over the body of spiders with a glass slide (diascopy), leading to pallor with refilling following the release of pressure. No other angiomas show this phenomenon. [ncbi.nlm.nih.gov]
- Swelling
[…] symptoms of the virus.[4] Unfortunately, while hepatitis A and B have a protective vaccine available, there are no vaccines available to protect against the HCV virus (hepatitis C), Once contracted, if left untreated, hepatitis C can cause the liver to swell [en.wikipedia.org]
- Fatigue
— The patient, a 34-year-old male coal miner, presented in May 1988 complaining of visual disturbances, fatigue, and night sweats of 6 months' duration. [jamanetwork.com]
Immune System
- Splenomegaly
These patients should be examined for the presence of palmar erythema, white nails with distal hyperemic bands, splenomegaly, ascites, jaundice, and asterixis. [jpgmonline.com]
An ultrasound abdomen was suggestive of liver cirrhosis with portal hypertension (portal vein diameter of 14 mm), ascites and splenomegaly. Thus, a diagnosis of cirrhosis liver with portal hypertension was made (CTP-9, Class B, and MELD – 11). [ijabmr.org]
[…] customers. [4] When associated with liver disease, spider angiomas may be numerous, large in size, [9] and appear in atypical locations [10] ; other findings may be present, including palmar erythema, muscle atrophy, gynecomastia, ascites, jaundice, splenomegaly [emedicine.medscape.com]
Cardiovascular
- Hypotension
In a patient with cirrhosis, multiple pleural and subpleural arteriolar nevi were demonstrated on gross and microscopic examination at autopsy. [4] • Improving hepatic function • Hypotension (Shock) • Discontinuation of the offending medication • Death [jpgmonline.com]
[…] resolve after liver transplantation. [6] Spider nevi occurring in the context of pregnancy or oral contraceptive use may regress postpartum or after discontinuation of medicine. [5] They may also regress after death or in situations resulting in severe hypotension [emedicine.medscape.com]
Liver, Gall & Pancreas
- Jaundice
Chronic Liver Disease can give rise to numerous extrahepatic disorders among which skin disease occupy a central place Jaundice, xerosis, pruritis, pigmentary changes, loss of pubic and axillary hairs, leuconychia, spider naevi, telangiectasias, striae [medical-dictionary.thefreedictionary.com]
Clinical examination reveals jaundice, spider naevi over chest and tender, palpable hepatomegaly with no... [evidence.nhs.uk]
In these topics Spider Angiomas Jaundice in Adults Physical Changes During Pregnancy Spider Angiomas [msdmanuals.com]
Spider telangiectases vary in size and number, tending to be larger and more numerous in people with severe liver disease when other cutaneous signs of liver disease may be present such as palmar erythema, leukonychia, and jaundice. [dermnetnz.org]
A 48-year-old-female presented with a history of abdominal distension and jaundice of 3-month duration. Physical examination revealed pallor, icterus, pedal edema, hepatospleenomegaly and tense ascites. [ijabmr.org]
Skin
- Palmar Erythema
erythema all are recognized sequelae of liver disease (12, 14). [medical-dictionary.thefreedictionary.com]
These patients should be examined for the presence of palmar erythema, white nails with distal hyperemic bands, splenomegaly, ascites, jaundice, and asterixis. [jpgmonline.com]
He will also be remembered for his poetry on the subject of alcoholic cirrhosis, spider naevi and palmar erythema and it is worthy of repetition[7]: An older Miss Muffett Decided to rough it And lived upon whisky and gin. [patient.info]
Spider telangiectases vary in size and number, tending to be larger and more numerous in people with severe liver disease when other cutaneous signs of liver disease may be present such as palmar erythema, leukonychia, and jaundice. [dermnetnz.org]
In pregnant women, palmar erythema may also be present. [5] Spider angiomas are common in otherwise healthy children and are present in 10-15% of healthy adults and young children. [1] International The frequency of spider angiomas (nevus araneus) is [emedicine.medscape.com]
- Skin Lesion
The lesion con… Skin diseases of the nose. [unboundmedicine.com]
Spider Naevi are a common skin lesion that can be easily removed with our 532 laser. In most instances the spider naevi can be removed in a single session with a few ”blasts” of the laser. [skinqure.co.uk]
When there is a single lesion it is called a spider nevus, when multiple- nevi. Spider nevi are very superficial skin lesions and distinct from spider veins. They look very much like a spider with fine radiating lines. [veindirectory.org]
[Facial skin lesions in male patients with liver cirrhosis: role of serum sex hormones and correlation with impaired liver function]. Zhonghua Gan Zang Bing Za Zhi 2013; 21: 354-8. Pirovino M, Linder R, Boss C, Kochli HP, Mahler F. [termedia.pl]
Race No racial predilection is reported for spider angioma (nevus araneus), but lesions are more apparent in light-skinned patients. [emedicine.medscape.com]
- Skin Disease
Chronic Liver Disease can give rise to numerous extrahepatic disorders among which skin disease occupy a central place Jaundice, xerosis, pruritis, pigmentary changes, loss of pubic and axillary hairs, leuconychia, spider naevi, telangiectasias, striae [medical-dictionary.thefreedictionary.com]
The lesion con… Skin diseases of the nose. [unboundmedicine.com]
Mucocutaneous spider angiomas in an adolescent with chronic liver disease. Arch Dis Child. 2018 Dec;103(12):1145. [PubMed: 29298760] 4. Yigider AP, Kayhan FT, Yigit O, Kavak A, Cingi C. Skin diseases of the nose. [ncbi.nlm.nih.gov]
- Leukonychia
Spider telangiectases vary in size and number, tending to be larger and more numerous in people with severe liver disease when other cutaneous signs of liver disease may be present such as palmar erythema, leukonychia, and jaundice. [dermnetnz.org]
When associated with liver disease, spider angiomas may be numerous, large in size, [9] and appear in atypical locations [10] ; other findings may be present, including palmar erythema, muscle atrophy, gynecomastia, ascites, jaundice, splenomegaly, [4] leukonychia [emedicine.medscape.com]
- Eruptions
His skin eruption started 4 months before admission as nontender, nonpruritic erythematous papules mainly on the face and dorsa of the hands. He drank three or four bottles of wine per week and "moonshine" once a month. [jamanetwork.com]
Differential Diagnosis 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 [ncbi.nlm.nih.gov]
Workup
Evaluation Solitary spider nevus in otherwise healthy individuals or pregnant women does not warrant further workup. A detailed history and focused physical exam can help to attribute multiple spider angioma to liver disease. [ncbi.nlm.nih.gov]
Treatment
Contact us: 01227 472288 [email protected] Book Online Menu Home About Us About Us/ why choose us Meet The Team Treatments Acne / Acne Scars Acne Rosacea Age Spots Allergy Clinic Anti-Ageing Treatments 8-point Facelift Face – Botox® & Fillers [skinandlaser.co.uk]
Our exceptional treatments panel only meets once a month and DD's case was considered in April 2008, we got treatment in June the same year. Hope this helps. [mumsnet.com]
Treatment is usually not necessary. [skinsupport.org.uk]
Clients should expect some redness following treatment and some small scabs can form, which will drop off a few days following treatment. Price from £50 [thebodydetoxclinic.co.uk]
Laser treatment Laser treatment can provide excellent results in the treatment of skin changes that arise from blood vessels. There a variety of different types, which can be readily treated. [skin55.co.uk]
Prognosis
Cutaneous signs of liver disease: value for prognosis of severe fibrosis and cirrhosis. Liver Int 2008; 28: 659-66. Younis I, Sarwar S, Butt Z, Tanveer S, Qaadir A, Jadoon NA. [termedia.pl]
Prognosis Benign lesions tend to resolve spontaneously but may take a number of years to do so. If associated with pregnancy they tend to go about six or seven months after delivery. [patient.info]
Cutaneous signs of liver disease: value for prognosis of severe fibrosis and cirrhosis. Liver Int. 2008 May. 28(5):659-66. [QxMD MEDLINE Link]. [Full Text]. Hane H, Yokota K, Kono M, Muro Y, Akiyama M. [emedicine.medscape.com]
[…] higher incidence of dyspnea, platypnea, clubbing and spider nevi. [13] Thus, this small, yet valuable, physical sign must be carefully looked for in patients with liver disease as it can provide important information not only regarding severity but also prognosis [jpgmonline.com]
The prognosis for patients with spider nevi is generally excellent unless they have underlying end-stage liver disease. (Level V) Review Questions References 1. Samant H, Kothadia JP. StatPearls [Internet]. [ncbi.nlm.nih.gov]
Etiology
Increased plasma levels of estrogen, vascular dilation, and neovascularisation are possible etiologies. [jpgmonline.com]
The exact etiology of the spider nevus (nevus araneus) is unclear. [emedicine.medscape.com]
It is typically painless, resembles a spider's body), and is surrounded by attenuated capillaries radiating in a spider-legged fashion, decreasing in size toward the margins.[1][2][3] Etiology Spider angiomas are usually benign but often can be suggestive [ncbi.nlm.nih.gov]
Epidemiology
Epidemiology[4] Multiple spider naevi are more indicative of underlying disease. They have been reported in 33% of healthy children. They show an equal sex incidence. [patient.info]
Multiple spider angiomas are characteristic of chronic liver disease with a specificity of 95%.[4] Epidemiology Prevalence of spider angiomas is highest among patients with cirrhosis, alcoholic hepatitis, and hepatopulmonary syndrome. [ncbi.nlm.nih.gov]
Although the finding of 5 or more spider angiomas is more common in persons with liver disease, many healthy children also have one or more of these lesions. [2] Epidemiology Frequency United States Young children and pregnant women most frequently exhibit [emedicine.medscape.com]
Pathophysiology
Mechanisms of Clinical Signs is the first consolidated text of its kind; designed to help medical students and junior doctors understand the pathophysiological mechanisms behind clinical signs. [books.google.de]
Pathophysiology of KMS is generallypresumed to be that of platelet trapping by abnormally proliferating endothelium within angioma. [academic.oup.com]
Pathophysiology Spider naevus is dilation of preexisting central arterioles from which numerous thin-walled capillary branches radiate like spider legs, carrying away freely flowing blood. [ncbi.nlm.nih.gov]
In children, the backs of the hands and fingers are commonly affected. [1, 3] Pathophysiology Vascular malformations can be classified into 6 categories: hamartomas, malformations, dilatations of preexisting vessels, hyperplasias, benign neoplasms, and [emedicine.medscape.com]
Prevention
[…] of Spider Naevus Yes, it may be possible to prevent Spider Naevus. [tabletwise.com]
While no specific preventive measures are known, you may prevent new spider nevi from forming by: avoiding hormone therapy wearing sunscreen on those areas most commonly affected, including the face, neck, and legs controlling your alcohol consumption [healthline.com]