Telangiectasia in Adult
Alerts and Notices
Synopsis

Telangiectases (spider veins) are permanently dilated superficial blood vessels. They may be capillaries, venules, or arterioles. They tend to increase in frequency and number with age, often due to actinic damage.
While telangiectases may be thought of as distinct clinical entities, they are also prominent features of certain diseases and may be clues to an underlying disorder. They can also be caused by medications, such as topical and oral steroids, as well as oral contraceptives.
Causes of telangiectases are many and include venous hypertension, local trauma, radiation damage, corticosteroid use, estrogen / progesterone excess, collagen vascular diseases, and multiple genodermatoses.
Telangiectases very rarely bleed. They are a cosmetic nuisance, and treatment is optional.
While telangiectases may be thought of as distinct clinical entities, they are also prominent features of certain diseases and may be clues to an underlying disorder. They can also be caused by medications, such as topical and oral steroids, as well as oral contraceptives.
Causes of telangiectases are many and include venous hypertension, local trauma, radiation damage, corticosteroid use, estrogen / progesterone excess, collagen vascular diseases, and multiple genodermatoses.
Telangiectases very rarely bleed. They are a cosmetic nuisance, and treatment is optional.
Codes
ICD10CM:
I78.1 – Nevus, non-neoplastic
SNOMEDCT:
247479008 – Telangiectasia disorder
I78.1 – Nevus, non-neoplastic
SNOMEDCT:
247479008 – Telangiectasia disorder
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
Rarely, telangiectasias may be confused with:
- Livedo reticularis or racemosa
- Angiokeratomas
- Venous lake
- Solar-damaged skin
- Post-surgical procedure – Laser, electro, cryo.
- Radiation dermatitis
- Basal cell carcinoma
- Estrogen excess – Cirrhosis, pregnancy, oral contraceptive use.
- Cushing syndrome
- Costal fringe
- Venous insufficiency / venous hypertension
- Collagen vascular disease – dermatomyositis, lupus erythematosus, scleroderma
- Steroid atrophy
- Xeroderma pigmentosum
- Rosacea
- Pseudoxanthoma elasticum
- Necrobiosis lipoidica
- Poikiloderma of Civatte
- Metastatic carcinoma
- Carcinoid syndrome
- Telangiectasia macularis eruptiva perstans
- Ataxia-telangiectasia
- Focal dermal hypoplasia
- Rothmund-Thomson syndrome
- Bloom syndrome
- Dyskeratosis congenita
- Generalized essential telangiectasia
- Hereditary hemorrhagic telangiectasia
- Unilateral nevoid telangiectasia syndrome
- Spider angioma (nevus araneus)
- Angioma serpiginosum
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Updated:02/15/2018

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