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Telangiectasia in Adult
Other Resources UpToDate PubMed

Telangiectasia in Adult

Contributors: Noah Craft MD, PhD, Lindy P. Fox MD, Lowell A. Goldsmith MD, MPH
Other Resources UpToDate PubMed


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.


I78.1 – Nevus, non-neoplastic

247479008 – Telangiectasia disorder

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Rarely, telangiectasias may be confused with:
  • Livedo reticularis or racemosa
  • Angiokeratoma
  • Venous lake
The differential diagnosis of multiple telangiectatic lesions is:
  • Solar-damaged skin
  • Post-surgical procedure – Laser, electro, cryo.
  • Radiation dermatitis
  • Nodular basal cell carcinoma
  • Estrogen excess – Cirrhosis, pregnancy, oral contraceptive use.
  • Cushing syndrome
  • Costal fringe
  • Venous insufficiency / venous hypertension
  • Collagen vascular disease – Dermatomyositis, Systemic lupus erythematosus, Scleroderma
  • Steroid atrophy
  • Xeroderma pigmentosum
  • Rosacea
  • Pseudoxanthoma elasticum
  • Necrobiosis lipoidica
  • Poikiloderma of Civatte
  • Metastatic cutaneous carcinoma
  • Carcinoid syndrome
  • Telangiectasia macularis eruptiva perstans
  • Ataxia-telangiectasia syndrome
  • Focal dermal hypoplasia
  • Rothmund-Thomson syndrome
  • Bloom syndrome
  • Dyskeratosis congenita
  • Generalized essential telangiectasia
  • Hereditary hemorrhagic telangiectasia
  • Unilateral nevoid telangiectasias
  • Spider angioma (nevus araneus)
  • Angioma serpiginosum

Best Tests

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Management Pearls

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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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Last Updated:02/15/2018
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Patient Information for Telangiectasia in Adult
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Telangiectasia in Adult
A medical illustration showing key findings of Telangiectasia : Telangiectasia
Clinical image of Telangiectasia - imageId=2767459. Click to open in gallery.  caption: 'A close-up of linear and branching red macules (and unrelated pustules).'
A close-up of linear and branching red macules (and unrelated pustules).
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