telangiectasia

(spider vein, angioectasia)

A small dilated blood vessel that can occur near the surface of the skin or mucous membranes, measuring less than one millimeter in diameter.

(Word decoding)
• tel- (telo-, tele-, teleo-): end, complete
• angi- (angio-, angei-): vessel
• ectasia: dilatation

They can develop anywhere on the body but are commonly seen on the face around the nose, cheeks and chin. They can also develop on the legs, specifically on the upper thigh, below the knee joint and around the ankles and they often have underlying venous reflux or "hidden varicose veins".

(Causes)
• Genetic: bloom syndrome, port-wine stain (nevus flammeus), Klippel-Trenaunay syndrome, Maffucci syndrome, hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome), ataxia-telangiectasia, Sturge-Weber syndrome, hypotrichosis-lymphedema-telangiectasia syndrome
• Acquired: Cushing's syndrome, chronic treatment with topical corticosteroids, chemotherapy, acne rosacea, blepharitis, carcinoid syndrome, limited systemic sclerosis, dermatomyositis, lupus, spider angiomas, Tempi syndrome
• Environmental: radiation, sun, cold exposure, venous hypertension for age, smoking, trauma to skin

(Types)
• Sinus (simple, linear)
• Arborizing
• Spider (star)
• Punctiform (papular)

(Comparison)
• spider veins: Pink or red veins less than 1mm in diameter. Feather-like, short, jagged fine lines.
• reticular veins: Blue or green veins 1-3 mm in diameter. Flatter, less twisted. When associated with telangiectasias, they are called "feeder veins".
• varicose veins: Purple or blue veins larger than 3 mm in diameter. Abnormally thick, full of twists and turns, enlarged, bulged.

(Stages of vein disease)
1. spider veins
2. varicose veins
3. swelling and skin discoloration
4. venous leg ulcers

(Treatment)
It is essential to firstly find and treat underlying venous reflux by duplex ultrasonography, because there is a clear association between leg telangiectasia and underlying venous reflux.
• Sclerotherapy: Injects a solution either a liquid or a foam, that makes the walls of the vein stick to each other, causing the entire vein to collapse, forcing blood to reroute through healthier veins. Preferred over laser.
• Laser: Heats up and damages the veins without injuring nearby tissues.

(Side effects of treatment)
• Inflammation around the injection site
• Hyperpigmentation (red treatment area)
• Allergic reaction to the solution used for treatment.
• Skin necrosis
• Air bubbles, that may cause visual disturbances, headaches, fainting and nausea.
• Blood clot, that may cause deep vein thrombosis with a risk of pulmonary embolism and stroke.

• Category

  Ataxia-Telangiectasia