Skin Vascular Lesions Flashcards
Vascular Tumours
Definition
Endothelial hyperplasia
Vascular Tumours
Presence at Birth
Usually postnatal
Vascular Tumours
M:F
1:3-5
Vascular Tumours
Natural History
Phases
Proliferating
Involuting
Involuted
Vascular Malformations
Definition
Congenital malformation with normal endothelial turnover
Vascular Malformations
Presence at Birth
100% at birth (not always obvious)
Vascular Malformations
M:F
1:1
Vascular Malformations
Natural History
Proportionate growth (can expand)
HEMANGIOMAS
Clinical Feature
• red or blue subcutaneous mass that is soft/compressible, blanches with pressure; feels like a “bag of
worms” when palpated
HEMANGIOMAS
Pathophysiology
- benign vascular tumour
* includes: cavernous hemangioma, capillary/infantile hemangioma, spider hemangioma
Does spider angioma blanch?
A spider angioma will blanch when the tip
of a paperclip is applied to the centre of
the lesion
Hot, firm red to blue plaques or
tumours
Hemangioma of
Infancy
Hemangioma of
Infancy
Pathophysiology
Benign vascular
proliferation of endothelial
lining
Hemangioma of
Infancy
Epidemiology
Appears shortly
after birth;
rarely may be
congenital
Hemangioma of
Infancy
Clinical Course
Appears shortly after birth, increases in size over months, then regresses 50% of lesions resolve spontaneously by 5 yr
Hemangioma of
Infancy
Management
10% require treatment due to functional
impairment (visual compromise, airway
obstruction, high output cardiac failure) or
cosmesis
Consider treatment if not gone by school
age; topical timolol, propranolol; systemic
corticosteroids; laser treatment; surgery
Provide early specialist referral or
treatment in infants with high-risk
hemangiomas
Central red arteriole with slender
branches, blanchable
Spider Angioma
Spider Angioma Synonym
(Campbell
Telangiectasia)
Spider Angioma
Pathophysiology
Can be associated with
hyperestrogenic state (e.g.
in liver disease, pregnancy,
OCP) but more often is not
Spider Angioma
Epidemiology
Any age
Spider Angioma
Clinical Course
Increase in number
over time
Spider Angioma
Management
Reassurance
Electrodesiccation or laser surgery if
patient wishes
Bright red to deep maroon, domeshaped
vascular papules, 1-5 mm
Site: trunk
Less friable compared to
Cherry Angioma
synonym of Cherry Angioma
(Campbell De
Morgan Spot)
Cherry Angioma
Pathophysiology
Benign vascular neoplasm
Cherry Angioma
Epidemiology
> 30 yr old
Cherry Angioma
Clinical Course
Lesions do not fade
in time
Lesions bleed
infrequently
Cherry Angioma
Management
Usually no treatment needed
Laser or electrocautery for small lesions
Excision of large lesions if necessary
Bright red, dome-shaped sessile or
pedunculated friable nodule
Sites: fingers, lips, mouth, trunk,
toes
Pyogenic
Granuloma
Pyogenic
Granuloma
Pathophysiology
Rapidly developing hemangioma Proliferation of capillaries with erosion of epidermis and neutrophilia
Pyogenic
Granuloma
Epidemiology
<30 yr old
Pyogenic
Granuloma
Clinical Course
Lesion grows rapidly over wk-mo, then stabilizes Lesion may persist indefinitely if untreated
Pyogenic
Granuloma
Management
Surgical excision with histologic
examination
Electrocautery; laser; cryotherapy
blue or violaceous
papular lesion occurring on the face,
lips, and ears
Venous Lake: benign blue or violaceous
papular lesion occurring on the face,
lips, and ears due to dilation of a venule.
Venous Lake DDx
Distinguished from malignant pigmented
lesions through diascopy, as compression
blanches the lesion
Red to blue macule present at birth that follows a
dermatomal distribution, rarely crosses midline
Nevus Flammeus
Nevus Flammeus synonym
(Port-wine stain)
Nevus Flammeus
Clinical Feature, site and course
Red to blue macule present at birth that follows a
dermatomal distribution, rarely crosses midline
Most common site: nape of neck
Never spontaneously regresses but grows in
proportion to the child
Nevus Flammeus
Pathophysiology
Congenital vascular malformation of dermal capillaries; rarely associated with Sturge-Weber syndrome (V1, V2 distribution)
Nevus Flammeus
Management
Laser or make-up
Pink-red irregular patches Midline macule on glabella,
or nuchal region, on newborns
Nevus Simplex
Nevus Simplex synonym
(salmon patch)
Nevus Simplex
Clinical Feature, site and course
Pink-red irregular patches Midline macule on glabella known as “Angel Kiss”; on nuchal region known as “Stork Bites” Present in 1/3 of newborns Majority regress spontaneously
Nevus Simplex
Pathophysiology
Congenital dilation of dermal
capillaries
Nevus Simplex
Management
No treatment
required
