Spider Telangiectasia

Spider telangiectasia is a condition resulting from dilated blood vessels and has a spider-like appearance. This condition earned its name due to having a central red papule, which can be perceived as the spider's body, and radially extending red lines, which can be perceived as the spider's legs.

Approximately 10 to 15 percent of children and adults have a solitary spider telangiectasis. Multiple spider telangiectasis is prevalent among pregnant women, women who are taking a combined oral contraceptive pill, and in patients with liver disease, such as cirrhosis resulting from alcohol abuse.

Spider telangiectasis is a vascular malformation that develops over time. The tiny muscle is unable to restrict the size of an arteriole. The increased pulsating flow via the vessel (central papule) results in the dilation of distal vessels (the red lines).

Spider telangiectasis may arise either spontaneously or be triggered by circulating oestrogen. Oestrogen levels are typically elevated in pregnant women, women taking combined oral contraceptives, or individuals with liver disease. Various vascular endothelial growth factors may also be involved in the development and progression of spider telangiectasis.

The face, neck, and upper chest are the most common sites where spider telangiectasis is found. It can also occur on the arms, hands, and other body sites.

Spider telangiectasis can differ in size and number. It tends to be larger and more numerous in individuals with severe liver disease who exhibit other cutaneous signs of liver disease, such as jaundice, palmar erythema, and leukonychia. A central dilated arteriole may exist without radial capillaries. Capillaries can vary in number, length, and diameter, and may also appear in a star shape.

As a result of trauma, these lesions can bleed for a short period of time. However, this condition typically does not result in any symptoms or complications.

The diagnosis of spider telangiectasis is determined by its appearance. Compression of the central arteriole results in the disappearance of the radial capillaries. Once compression is relieved, rapid refilling is observed. This can be assessed using a dermatoscope.

Spider telangiectasis is harmless and does not require treatment. It can be removed by destroying the feeding central arteriole, though this may result in a small scar. Available treatment options include electrosurgery, intense pulsed light, and vascular laser.

Spider telangiectasis can disappear over time or continue to persist. If spider telangiectasis was triggered by oestrogen, it may resolve within six months postpartum, or following discontinuation of the combined contraceptive pill. These lesions may reappear after an initially successful treatment.