Skin Vascular Lesions

Question 1

Vascular Tumours

Definition

Answer 1

Endothelial hyperplasia

Question 2

Vascular Tumours

Presence at Birth

Answer 2

Usually postnatal

Question 3

Vascular Tumours

M:F

Answer 3

1:3-5

Question 4

Vascular Tumours

Natural History

Answer 4

Phases
Proliferating
Involuting
Involuted

Question 5

Vascular Malformations

Definition

Answer 5

Congenital malformation with normal endothelial turnover

Question 6

Vascular Malformations

Presence at Birth

Answer 6

100% at birth (not always obvious)

Question 7

Vascular Malformations

M:F

Answer 7

1:1

Question 8

Vascular Malformations

Natural History

Answer 8

Proportionate growth (can expand)

Question 9

HEMANGIOMAS

Clinical Feature

Answer 9

• red or blue subcutaneous mass that is soft/compressible, blanches with pressure; feels like a “bag of
worms” when palpated

Question 10

HEMANGIOMAS

Pathophysiology

Answer 10

• benign vascular tumour

* includes: cavernous hemangioma, capillary/infantile hemangioma, spider hemangioma

Question 11

Does spider angioma blanch?

Answer 11

A spider angioma will blanch when the tip
of a paperclip is applied to the centre of
the lesion

Question 12

Hot, firm red to blue plaques or

tumours

Answer 12

Hemangioma of

Infancy

Question 13

Hemangioma of
Infancy
Pathophysiology

Answer 13

Benign vascular
proliferation of endothelial
lining

Question 14

Hemangioma of
Infancy
Epidemiology

Answer 14

Appears shortly
after birth;
rarely may be
congenital

Question 15

Hemangioma of
Infancy
Clinical Course

Answer 15

Appears shortly after
birth, increases in size
over months, then
regresses
50% of lesions resolve
spontaneously by 5 yr

Question 16

Hemangioma of
Infancy
Management

Answer 16

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

Question 17

Central red arteriole with slender

branches, blanchable

Answer 17

Spider Angioma

Question 18

Spider Angioma Synonym

Answer 18

(Campbell

Telangiectasia)

Question 19

Spider Angioma

Pathophysiology

Answer 19

Can be associated with
hyperestrogenic state (e.g.
in liver disease, pregnancy,
OCP) but more often is not

Question 20

Spider Angioma

Epidemiology

Answer 20

Any age

Question 21

Spider Angioma

Clinical Course

Answer 21

Increase in number

over time

Question 22

Spider Angioma

Management

Answer 22

Reassurance
Electrodesiccation or laser surgery if
patient wishes

Question 23

Bright red to deep maroon, domeshaped
vascular papules, 1-5 mm
Site: trunk
Less friable compared to

Answer 23

Cherry Angioma

Question 24

synonym of Cherry Angioma

Answer 24

(Campbell De

Morgan Spot)

Question 25

Cherry Angioma

Pathophysiology

Answer 25

Benign vascular neoplasm

Question 26

Cherry Angioma

Epidemiology

Answer 26

> 30 yr old

Question 27

Cherry Angioma

Clinical Course

Answer 27

Lesions do not fade
in time
Lesions bleed
infrequently

Question 28

Cherry Angioma

Management

Answer 28

Usually no treatment needed
Laser or electrocautery for small lesions
Excision of large lesions if necessary

Question 29

Bright red, dome-shaped sessile or
pedunculated friable nodule
Sites: fingers, lips, mouth, trunk,
toes

Answer 29

Pyogenic

Granuloma

Question 30

Pyogenic
Granuloma
Pathophysiology

Answer 30

Rapidly developing
hemangioma
Proliferation of capillaries
with erosion of epidermis
and neutrophilia

Question 31

Pyogenic
Granuloma
Epidemiology

Answer 31

<30 yr old

Question 32

Pyogenic
Granuloma
Clinical Course

Answer 32

Lesion grows rapidly
over wk-mo, then
stabilizes
Lesion may persist
indefinitely if untreated

Question 33

Pyogenic
Granuloma
Management

Answer 33

Surgical excision with histologic
examination
Electrocautery; laser; cryotherapy

Question 34

blue or violaceous
papular lesion occurring on the face,
lips, and ears

Answer 34

Venous Lake: benign blue or violaceous
papular lesion occurring on the face,
lips, and ears due to dilation of a venule.

Question 35

Venous Lake DDx

Answer 35

Distinguished from malignant pigmented
lesions through diascopy, as compression
blanches the lesion

Question 36

Red to blue macule present at birth that follows a

dermatomal distribution, rarely crosses midline

Answer 36

Nevus Flammeus

Question 37

Nevus Flammeus synonym

Answer 37

(Port-wine stain)

Question 38

Nevus Flammeus

Clinical Feature, site and course

Answer 38

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

Question 39

Nevus Flammeus

Pathophysiology

Answer 39

Congenital vascular
malformation of dermal
capillaries; rarely associated
with Sturge-Weber syndrome
(V1, V2 distribution)

Question 40

Nevus Flammeus

Management

Answer 40

Laser or make-up

Question 41

Pink-red irregular patches Midline macule on glabella,

or nuchal region, on newborns

Answer 41

Nevus Simplex

Question 42

Nevus Simplex synonym

Answer 42

(salmon patch)

Question 43

Nevus Simplex

Clinical Feature, site and course

Answer 43

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

Question 44

Nevus Simplex

Pathophysiology

Answer 44

Congenital dilation of dermal

capillaries

Question 45

Nevus Simplex

Management

Answer 45

No treatment

required