Telangiectasia

Telangiectasias, or spider veins, are small dilated blood vessels near the surface of the skin; usually they measure only a few millimeters. They can develop anywhere on the body but commonly 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.

These are actually developmental abnormalities but can closely mimic the behaviour of benign vascular neoplasms. They may be composed of abnormal aggregations of arterioles, capillaries, or venules.

Chronic treatment with topical corticosteroids may lead to telangiectasia.^[1]

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Features

Telangiectasias can result in naevus flammeus (port-wine stain), which is a flat birthmark on the head or neck that spontaneously regresses. A port-wine stain, if present, will grow proportionately with the child. There is a high association with Sturge-Weber syndrome, a nevus formation in the skin supplied by the trigeminal nerve and associated with glaucoma, meningeal angiomas, and mental retardation. Finally, spider telangiectasias are a radial array of tiny arterioles that commonly occur in pregnant women and in patients with hepatic cirrhosis. In men, they are related to high estrogen levels secondary to liver disease.

Because telangiectasias are vascular lesions, they blanch when tested with diascopy.

Associated conditions

Telangiectasias may occur in a number of diseases:

• CREST syndrome (a variant of scleroderma)
• hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome)
• Ataxia telangiectasia
• Carcinoid syndrome
• Acne rosacea

Causes

The main factors that play a role in the development and continuity of spider veins include;^{[citation needed]}

Heredity- Where family history plays a part in individual development.^{[citation needed]}

Age - The development of spider veins may occur at any age but usually occurs between 18 and 35 years, and peaks between 50 and 60 years.^{[citation needed]}

Gender – Females are affected approximately four to one to males.^{[citation needed]}

Pregnancy – Pregnancy is a key factor contributing to the formation of varicose and spider veins. The most important factor is circulating hormones that weaken vein walls. There's also a significant increase in the blood volume during pregnancy, which tends to distend veins, causing valve dysfunction which leads to blood pooling in the veins. Moreover,later in pregnancy, the enlarged uterus can compress veins, causing higher vein pressure leading to dilated veins. Varicose veins that form during pregnancy may spontaneously improve or even disappear a few months after delivery.^{[citation needed]}

Lifestyle/Occupation - Those who are involved with prolonged sitting or standing in their daily activities have an increased risk of developing varicose veins. Therefore, the weight of the blood continuously pressing against the closed valves causes them to fail, leading to vein distention.^{[citation needed]}

The Lifestyle factors that can contribute to the development of varicose and spider veins entail:

• Prolonged standing or sitting^{[citation needed]}
• Binding clothing^{[citation needed]}
• Chronic constipation^{[citation needed]}
• Birth control pills/estrogen replacement therapy^{[citation needed]}
• High-heeled shoes^{[citation needed]}
• Menstrual cycle^{[citation needed]}
• Obesity^{[citation needed]}
• Sedentary lifestyle^{[citation needed]}
• Number of pregnancies^{[citation needed]}
• Westernized population^{[citation needed]}
• Heat^{[citation needed]}

Treatment

Telangiectasias are often treated with laser or IPL therapy. There have been medication based treatments available for over 50 years. Laser therapy uses light beam that is pulsed onto the veins in order to seal them off, causing them to dissolve. These light-based treatment requires adequate heating of the veins. For optimal results, several laser treatments are usually necessary. A Sclerosant medication is injected into the diseased vein so it hardens and eventually shrinks away.

References

1. ^ Treatment of Seborrheic Dermatitis- May 1, 2000 - American Academy of Family Physicians. Retrieved on 2007-06-01.