A spider angioma or spider naevus (plural: spider naevi), also nevus araneus, is a type of telangiectasis (swollen, spider-like blood vessels on the skin) found slightly beneath the skin's surface, often containing a central red spot and deep reddish extensions (see Blood color) which radiate outwards like a

spider's web A spider web, spiderweb, spider's web, or cobweb (from the archaic word '' coppe'', meaning "spider") is a structure created by a spider out of proteinaceous spider silk extruded from its spinnerets, generally meant to catch its prey. ...

or a

spider Spiders (order Araneae) are air-breathing arthropods that have eight legs, chelicerae with fangs generally able to inject venom, and spinnerets that extrude silk. They are the largest order of arachnids and rank seventh in total species ...

's legs. They are common and often

benign Malignancy () is the tendency of a medical condition to become progressively worse. Malignancy is most familiar as a characterization of cancer. A ''malignant'' tumor contrasts with a non-cancerous ''benign'' tumor in that a malignancy is not s ...

, presenting in around 10–15% of healthy adults and young children. However, having more than three spider angiomas is likely to be abnormal and may be a sign of

liver disease Liver disease, or hepatic disease, is any of many diseases of the liver. If long-lasting it is termed chronic liver disease. Although the diseases differ in detail, liver diseases often have features in common. Signs and symptoms Some of the si ...

and/or hepatitis C (HCV virus); it also suggests the probability of

esophageal varices Esophageal varices are extremely dilated sub-mucosal veins in the lower third of the esophagus. They are most often a consequence of portal hypertension, commonly due to cirrhosis. People with esophageal varices have a strong tendency to develop s ...

Signs and symptoms

Spider angiomas are found only in the distribution of the

superior vena cava The superior vena cava (SVC) is the superior of the two venae cavae, the great venous trunks that return deoxygenated blood from the systemic circulation to the right atrium of the heart. It is a large-diameter (24 mm) short length vein th ...

, and are thus commonly found on the

face The face is the front of an animal's head that features the eyes, nose and mouth, and through which animals express many of their emotions. The face is crucial for human identity, and damage such as scarring or developmental deformities may aff ...

neck The neck is the part of the body on many vertebrates that connects the head with the torso. The neck supports the weight of the head and protects the nerves that carry sensory and motor information from the brain down to the rest of the body. In ...

, upper part of the

torso The torso or trunk is an anatomical term for the central part, or the core, of the body of many animals (including humans), from which the head, neck, limbs, tail and other appendages extend. The tetrapod torso — including that of a hu ...

, and arms.

Cause

Spider angiomas form due to failure of the sphincteric muscle surrounding a

cutaneous Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other animal coverings, such as the arthropod exoskeleton, have different d ...

arteriole An arteriole is a small-diameter blood vessel in the microcirculation that extends and branches out from an artery and leads to capillaries. Arterioles have muscular walls (usually only one to two layers of smooth muscle cells) and are the primar ...

. The central red dot is the dilated arteriole and the red "spider legs" are small capillaries carrying away the freely flowing blood. If momentary pressure is applied, it is possible to see the emptied capillaries refilling from the center. No other

angioma Angiomas are benign tumors derived from cells of the vascular or lymphatic vessel walls (endothelium) or derived from cells of the tissues surrounding these vessels. Angiomas are a frequent occurrence as patients age, but they might be an indicat ...

s show this phenomenon. The dilation, in turn, is caused by increased

estrogen Estrogen or oestrogen is a category of sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three major endogenous estrogens that have estrogenic hormonal ac ...

levels in the blood. Many

pregnant Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but ca ...

women and women using

hormonal contraception Hormonal contraception refers to birth control methods that act on the endocrine system. Almost all methods are composed of steroid hormones, although in India one selective estrogen receptor modulator is marketed as a contraceptive. The origina ...

have spider angiomas, which is due to high estrogen levels in their blood. Individuals with significant

also show many spider angiomas, as their liver cannot metabolize circulating

s, specifically

estrone Estrone (E1), also spelled oestrone, is a steroid, a weak estrogen, and a minor female sex hormone. It is one of three major endogenous estrogens, the others being estradiol and estriol. Estrone, as well as the other estrogens, are synthesized ...

, which derives from the androgen

androstenedione Androstenedione, or 4-androstenedione (abbreviated as A4 or Δ4-dione), also known as androst-4-ene-3,17-dione, is an endogenous weak androgen steroid hormone and intermediate in the biosynthesis of estrone and of testosterone from dehy ...

. About 33% of patients with

cirrhosis Cirrhosis, also known as liver cirrhosis or hepatic cirrhosis, and end-stage liver disease, is the impaired liver function caused by the formation of scar tissue known as fibrosis due to damage caused by liver disease. Damage causes tissue rep ...

have spider angiomas. Hepatitis C is an infection that can lead to irreversible liver damage. The hepatitis C virus (HCV) spreads through contaminated blood, and people are often infected by sharing drug paraphernalia or unsanitized tattoo guns and needles, piercing equipment, or manicure tools. To make matters worse, symptoms of the HCV virus can take years to appear, and this is likely why most of those infected with hepatitis C do not even realize that they are infected, and can continue to spread the virus unknowingly. Unfortunately, many symptoms do not start to appear until some damage to the liver has been done. Unlike in the past when hepatitis C was not curable and continued to worsen as years passed, today most positive hepatitis C (HCV virus) cases (95-98%) are now curable by taking a fairly newer treatment in the form of a prescribed daily oral medication for the full duration of 12 weeks. This treatment is usually well tolerated, with little to no side effects whatsoever. Spider angiomas (spider-like blood vessels on the skin) are one of the main symptoms caused by a hepatitis C (HCV virus) infection. Discovering an infected patient with hepatitis C early on in the infection phase increases the chances of the virus being successfully treated and cured by oral medication. Some patients can be infected with hepatitis C for decades without knowing, and without experiencing any signs or symptoms of the virus. 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 or become inflamed, making it difficult to function adequately in order to properly filter out chemicals and toxins. When the hepatits C (HCV) infection turns chronic, it can cause full-blown cirrhosis of the liver (scarring of the liver), making it difficult for the liver to filter out waste and to store nutrients. This can also lead to liver cancer and eventually will lead to liver failure.

Diagnosis

Diagnosis is by

clinical examination In a physical examination, medical examination, or clinical examination, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the pat ...

. Spider naevi are most commonly seen by general practitioners, or dermatologists. Whilst a

lesion A lesion is any damage or abnormal change in the tissue of an organism, usually caused by disease or trauma. ''Lesion'' is derived from the Latin "injury". Lesions may occur in plants as well as animals. Types There is no designated classif ...

can be identified as a spider naevus, this is not a

diagnosis Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine "cause and effect". In systems engin ...

in itself. The clinical picture should be indicative of whether there is underlying disease that should be investigated.

Treatment

Spider angiomas are

asymptomatic In medicine, any disease is classified asymptomatic if a patient tests as carrier for a disease or infection but experiences no symptoms. Whenever a medical condition fails to show noticeable symptoms after a diagnosis it might be considered a ...

and usually 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. In women taking oral contraceptives, they may resolve after stopping these contraceptives. For spider angiomas on the face, techniques such as

electrodesiccation Cauterization (or cauterisation, or cautery) is a medical practice or technique of burning a part of a body to remove or close off a part of it. It destroys some tissue in an attempt to mitigate bleeding and damage, remove an undesired growth, o ...

and laser treatment can be used to remove the lesion. There is a small risk of a

scar A scar (or scar tissue) is an area of fibrous tissue that replaces normal skin after an injury. Scars result from the biological process of wound repair in the skin, as well as in other organs, and tissues of the body. Thus, scarring is a ...

, however it usually leaves nothing.

References

External links