Teleangiectasia I78.8

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 13.10.2021

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Synonym(s)

Spider veins

History
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The term was first used by Graf in 1807.

Definition
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Permanently dilated skin capillaries visible to the naked eye with a diameter of =/< 0.1 cm. Teleangiectasias are still visible to the naked eye from a distance of about 2 m.

Teleangiectasias disappear under moderate glass spatula pressure. They are listed together with reticular varicosities (>0.2cm), when localized to the lower extremity, in the CEAP classification under C1 (clinic) as signs of early cutaneous varicosis.

Teleangiectasia may be localized, disseminated, or systematized in the setting of vascular malformation.

Classification
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Six clinical forms are distinguished:

  • Punctate telangiectasia
  • Linear or sinusoidal telangiectasia
  • Single branched telangiectasia
  • Reticular branching telangiectasia
  • Patchy, spatter-like telangiectasia (e.g. in progeressive scleroderma)
  • Nevus araneus (spider naevus) with centrally pulsating vessel.

Etiopathogenesis
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Teleangiectasias occur:

as primary telangiectasias

  • in the context of congenital vascular malformations
  • idiopathic without recognizable cause

secondary (or symptomatic) acquired telangiectasias

  • exogenously induced telangiectasia (chronic UV exposure, long-term systemic or local corticosteroid therapy)
  • monitor-like in systemic diseases (e.g. progressive scleroderma; liver cirrhosis)
  • as a disease symptom in primary cutaneous diseases (e.g. rosacea)

Clinical features
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Diseases characterized by telangiectasia:

Differential diagnosis
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Teleangiectasias are to be distinguished from veinctasias (phlebectasias). These have a larger calibre, are tortuous and are bluish or blue-red in colour. The most common phelbectasias are spider vein varicose veins, which occur more frequently in connective tissue weakness and CVI.

Therapy
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In case of cosmetic disorder laser treatment with argon laser or pulsed dye laser. Alternatively, sclerotherapy with sclerosing agents containing polidocanol (see sclerosing below), stitching with diathermy needle. If necessary also covering measures ( camouflage as e.g. with Dermacolor). Furthermore, consistent sun protection is important, see also sunscreens (e.g. with Anthelios, ROC sunscreen, Contralum ultra).

Literature
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  1. Allegra C et al (Union of Phlebology Working Group) (2003) The "C" of CEAP: suggested definitions and refinements: an International Union ofPhlebology conference of experts. J Vasc Surg 37:129-131.
  2. Pannier F et al (2010) Cutaneous varicose veins. In: T Noppeney, H Nüllen Diagnosis and therapy of varicosis. Springer Medizin Verlag Heidelberg pp 150 -153

Incoming links (1)

Phlebectasia;

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Last updated on: 13.10.2021