Cherry angioma D18.01

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 08.10.2021

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Synonym(s)

Cherry-angioma; De Morgan spot; Haemangioma senile; Haemangioma seniles; haemangioma tardives; hemangioma senile; hemangioma seniles; Morgan stain; Ruby stain; telangiectasia papulosa disseminata

Definition
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Harmless, frequent, localized or multiple capillary neoplasm that occurs mainly in older people.

An eruptive occurrence of "senile" angiomas can be an expression of a systemic disease (e.g. a lymphoproliferative systemic disease). They may be associated with POEMS syndrome or Castleman's lymphoma.

Etiopathogenesis
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The etiopathogenesis of senile (tardive) angiomas is unknown. Thus, the angiogenic factors leading to the cutaneous vascular proliferations are also unknown.

Serum lipids: Normally, angiogenic factors are synthesized in the human body to compensate for the occlusive effects of atherogenic substances such as serum lipids. In a larger study (n=244 subjects), mean levels of total cholesterol, triglycerides as well as lipoproteins were shown to be higher in subjects with senile angiomas than in controls, with significant differences in total cholesterol and low-density lipoproteins and triglycerides (P < 0.05) (Darjani A et al 2018).

Drugs: A bivariate analysis of patients with benign prostatic hyperplasia demonstrated an association between the eruptive occurrence of cherry angiomas and the application of tamsulosin. Tamsulosin may thus be a possible risk factor for the development of cherry angiomas. Clopidogrel hingegven seems to play a protective role (Nazer RI et al 2020).

Melanoma and cherry angiomas: Versch. Investigators found a significant association between the incidence of melanoma and eruptive cherry angiomas in younger patients (≤50 years). This association was no longer elicitable in older patients (Corazza M et al. 2019).

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Manifestation
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Senile angioma is the most common form of acquired cutaneous vascular proliferation. It increases with age (predominantly from the 4th decade of life) due to various angiogenic factors. The exact pathogenesis is unknown. A certain predilection is detectable in the seborrheic skin type. Increased occurrence during pregnancy and in prolactin-producing tumors.

Localization
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Mainly on the trunk, less frequently on the extremities.

Clinical features
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Completely asymptomatic, 0.1-0, cm in size, sharply circumscribed, initially bright red, later dark red to purple, soft, flat papules with a smooth, shiny surface. They may be solitary but may also be very numerous. Fading under glass spatula pressure. In case of thrombosis (e.g. after banal trauma) the senile angiomas may appear as hard, black papules (DD: melanoma, malignant, nodular).

Histology
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Convolute of ectatic capillary vessels in the papillary stratum.

Therapy
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A medical indication for removal is only given in case of constant mechanical irritation at unfavorable localizations.

If desired: electrocautery or laser treatment(argon laser, dye laser).

Alternative: Therapeutically, sclerotherapy with sodium tetradecyl sulfate 3% proves to be effective. It offers an economical alternative to other available conventional methods (Jairath V et al. 2014).

Literature
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  1. Aghassi D (2000) Time-sequence histologic imaging of laser-treated cherry angiomas with in vivo confocal microscopy. J Am Acad Dermatol 43: 37-41
  2. Corazza M et al (2019) Eruptive cherry angiomas and skin melanoma: a fortuitous association? Melanoma Res 29:313-317.
  3. Darjani A et al (2018) Evaluation of lipid profile in patients with cherry angioma: A case-control study in Guilan, Iran. Dermatol Res Pract 2018:4639248.
  4. Jairath V et al (2014) Is sclerotherapy useful for cherry angiomas? Dermatol Surg 40:1022-1027.

  5. Nazer RI et al (2020) Cherry angioma: A case-control study. J Family Community Med 27:109-113.

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Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 08.10.2021