Cherry Hemangioma Clinical Presentation

Updated: Apr 30, 2018
  • Author: Clarence William Brown, Jr, MD, FAAD; Chief Editor: Dirk M Elston, MD  more...
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Presentation

History

Cherry angiomas typically present in the third or fourth decades of life, and early lesions may appear as small red macules. Lesions may be found on all body sites, but usually, the mucous membranes are spared. Most patients report an increase in number and size of individual lesions with advancing age.

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Physical Examination

Cherry angiomas can be found on every aspect of the integument—both in sun-exposed and in non‒sun-exposed areas, even including the scalp and genitalia. [6]

On physical examination, lesions may have a variable appearance, ranging from a small red macule to a larger dome-topped or polypoid papule. The color of the lesions typically is described as bright cherry red, but the lesions may appear more violaceous (purple) over time (see the image below).

A large polypoid angioma, deeply red to violaceous A large polypoid angioma, deeply red to violaceous cherry, appears in the center of the field. Surrounding the angioma are several small bright red macules and papules that represent cherry hemangiomas in the earlier stages of evolution.

Rarely, a lesion demonstrates a dark brown to an almost black color when a hemorrhagic plug occupies the vascular lumen, often raising concern about the possibility of a malignant melanoma.

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Complications

Cherry angiomas are, by definition, benign; however, periodically these lesions may experience trama and bleed profusely or become inflamed and thrombosed. Hemorrhages and secondary infection may complicate the course of traumatized lesions, often requiring surgical removal of the inflamed angioma.

The gradual appearance of multiple cherry angiomas over many years is common and often is expected; however, the sudden appearance of multiple cutaneous lesions always should raise concerns that the lesions may accompany the development of an internal malignancy.

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