Telangiectasia

Telangiectasia (Spider Vein)
1. Permanent dilation of small blood vessels (capillaries) near the skin surface or on the mucous membranes
2. Lesions may appear on the Tongue, lips and Palate, Conjunctiva, nail beds or involve any skin surface
3. Frequently located on the lower legs

Inherited (Genetic Syndromes)
1. Ataxia Telangiectasia or related conditions (e.g. Bloom Syndrome)
2. Hereditary Hemorrhagic Telangiectasia (Osler-Weber-Rendu Syndrome)
3. Numerous other more rare genetic disorders with Telangiectasias exist
4. Generalized essential Telangiectasia
  1. Uncommon cause of widespread Telangiectasia (esp. on legs), typically in adult women
Acquired
1. Rosacea
2. Cirrhosis (e.g. Caput Medusa)
3. Cushing Syndrome
4. Pregnancy
5. Scleroderma (Systemic Sclerosis)
6. Chronic Cutaneous Lupus (CCLE, Discoid Lupus)
7. Necrobiosis Lipoidica
8. Carcinoid Syndrome
9. Dermatomyositis
Trauma
1. Sun Damaged Skin
2. Hypertrophic Scar
Malignancy
1. Basal Cell Carcinoma
2. Kaposi Sarcoma
3. Merkel Cell Carcinoma
4. Lymphoma (e.g. Cutaneous T-Cell Lymphoma, Invasive B Cell Lymphoma)
Medications
1. Calcium Channel Blockers (and other vasodilating medications)
  1. Sun-exposed areas
2. Corticosteroids
  1. Associated with longterm use of either topical or Systemic Corticosteroids
  2. May also occur with intralesional Corticosteroid Injection

Papular Telangiectasia
1. Cherry Angioma
2. Angiokeratoma
3. Basal Cell Carcinoma
4. Angiofibroma
Macular Telangiectasia as Primary Lesions
1. Skin Atrophy
  1. Broca's Telangiactasias
  2. Purpura Annularis Telangiectodes of Majocchi (Majocchi's disease)
2. Absent Skin Atrophy
  1. High Estrogen State (e.g. Pregnancy)
    1. Unilateral Nevoid Telangiectasia
    2. Spider Nevi (Spider Angioma)
      1. Red, raised lesions on face, neck, arms and chest
      2. Occur in up to 67% of pregnancies and resolve postpartum in 75% of cases
  2. Elderly
    1. Costal Fringe
      1. Band of Telangiectasias along the anterolateral costal margins
  3. Child and Teen
    1. Upper half of body
      1. Capillary malformation (e.g. Port-Wine Stain, Nevus Simplex)
    2. Lower half of body
      1. Angioma Serpiginosum
  4. HIV
    1. HIV-Related Telangiectasia
Macular Telangiectasia as Secondary Lesions (associated with broader skin or systemic disorder)
1. Skin Atrophy
  1. Sun Damaged Skin (Poikiloderma of Civatte)
  2. Longterm Topical Corticosteroid-related skin damage
  3. Radiation Therapy Induced Skin Changes
  4. Scleroderma
  5. Discoid Lupus (Telangiectoid Variant)
  6. Cutaneous T-Cell Lymphoma (Poikiloderma Atrophicans Vasculare)
  7. Angiolupoid Sarcoidosis
2. Absent Skin Atrophy

Radiofrequency Surgery (Electrosurgery)
1. Coagulation or Electrodesiccation of involved superficial vessels
Laser Photorejuvenation
Intense Pulse Light Therapy
Sclerotherapy