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Begin your examination by asking the patient how long he has had the spider angiomas and where they’re located. Then carefully examine him yourself, noting the size and location of the angiomas. On palpation, the angiomas may be slightly warmer than the surrounding skin and may have a pulsating central body. Also, check for other skin abnormalities, such as jaundice, dryness, and palmar erythema.
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
❑ Acne rosacea
❑ Actinic damage
❑ Essential/venous hypertension
❑ Cherry angioma
❑ Senile angioma
❑ Pregnancy
❑ Cirrhosis
❑ Systemic lupus erythematosus
❑ Dermatomyositis
❑ Scleroderma
❑ Kaposi sarcoma
❑ Poikiloderma
❑ Port wine stain
❑ Cavernous hemangioma
❑ Venous lake
❑ Carcinoid
❑ Ataxia-telangiectasia
❑ Hereditary hemorrhagic telangiectasia
Linear telangiectasias are simple red or blue lines that blanch with pressure and disappear with diascopy. They are common with actinic damage, rosacea, carcinoid, ataxia-telangiectasia, or cutaneous inflammation (such as discoid lupus).
Spider angiomata have a central pulsating punctum (seen with diascopy), radial legs, and a halo of pallor caused by a vascular steal phenomenon.
Periungual nailfold telangiectasias, resembling glomeruli on 10-fold magnification, are found in lupus, scleroderma, and dermatomyositis.
Source: Field Guide to Bedside Diagnosis, 2007
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