Diagnostic Considerations

Also consider telangiectatic mats, which are flat patches of tiny vessels of uniform size with no central vessel.

Spider telangiectasia has been used to describe leg telangiectases, most commonly appreciated in women. It is not considered synonymous with spider angioma (nevus araneus). See Varicose Veins and Spider Veins.

Differential Diagnoses

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Finn SM, Rowland M, Lawlor F, Kinsella W, Chan L, Byrne O, et al. The significance of cutaneous spider naevi in children. Arch Dis Child. 2006 Jul. 91(7):604-5. [QxMD MEDLINE Link]. [Full Text].
Ali MA. Spider nevi secondary to alcoholic chronic liver disease. Cleve Clin J Med. 2022 Jun 1. 89 (6):301-302. [QxMD MEDLINE Link]. [Full Text].
Connor SG, Parizel PM, Wycoco V, Prentice DA. The relationship between spider naevi & de novo arteriovenous malformations in chronic liver disease. BJR Case Rep. 2022 Sep 12. 8 (5):20220081. [QxMD MEDLINE Link]. [Full Text].
Requena L, Sangueza OP. Cutaneous vascular anomalies. Part I. Hamartomas, malformations, and dilation of preexisting vessels. J Am Acad Dermatol. 1997 Oct. 37(4):523-49; quiz 549-52. [QxMD MEDLINE Link]. [Full Text].
Henry F, Quatresooz P, Valverde-Lopez JC, Piérard GE. Blood vessel changes during pregnancy: a review. Am J Clin Dermatol. 2006. 7(1):65-9. [QxMD MEDLINE Link]. [Full Text].
Graham-Brown RA. Hepatobiliary System and the Skin. Irwin Freedberg AE, Klaus Wolff, K Frank Austen, Lowell Goldsmith, Stephen Katz, Thomas Fitzpatric. Fitzpatrick's Dermatology In General Medicine. Fifth. New York: McGraw-Hill; 1999. 1918.
Salem A, Gamil H, Hamed M, Galal S. Nail changes in patients with liver disease. J Eur Acad Dermatol Venereol. 2010 Jun. 24(6):649-54. [QxMD MEDLINE Link]. [Full Text].
Li H, Wang R, Méndez-Sánchez N, et al. Impact of spider nevus and subcutaneous collateral vessel of chest/abdominal wall on outcomes of liver cirrhosis. Arch Med Sci. 2019 Mar. 15 (2):434-448. [QxMD MEDLINE Link]. [Full Text].
Chuh A, Zawar V, Sciallis G. Does dermatoscopy facilitate the detection and diagnosis of vascular skin lesions? A case-control study. J R Coll Physicians Edinb. 2018 Sep. 48 (3):210-216. [QxMD MEDLINE Link].
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Sivarajan V, Al Aissami M, Maclaren W, Mackay IR. Recurrence of spider naevi following treatment with 585 nm pulsed dye laser. J Plast Reconstr Aesthet Surg. 2007. 60(6):668-71. [QxMD MEDLINE Link]. [Full Text].
Becher GL, Cameron H, Moseley H. Treatment of superficial vascular lesions with the KTP 532-nm laser: experience with 647 patients. Lasers Med Sci. 2014 Jan. 29 (1):267-71. [QxMD MEDLINE Link]. [Full Text].
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Kono T, Sakurai H, Groff WF, Chan HH, Takeuchi M, Yamaki T, et al. Comparison study of a traditional pulsed dye laser versus a long-pulsed dye laser in the treatment of early childhood hemangiomas. Lasers Surg Med. 2006 Feb. 38(2):112-5. [QxMD MEDLINE Link]. [Full Text].
Michel JL. Treatment of hemangiomas with 595 nm pulsed dye laser dermobeam. Eur J Dermatol. 2003 Mar-Apr. 13(2):136-41. [QxMD MEDLINE Link].
Tan E, Vinciullo C. Pulsed dye laser treatment of spider telangiectasia. Australas J Dermatol. 1997 Feb. 38(1):22-5. [QxMD MEDLINE Link]. [Full Text].
Tan OT, Gilchrest BA. Laser therapy for selected cutaneous vascular lesions in the pediatric population: a review. Pediatrics. 1988 Oct. 82(4):652-62. [QxMD MEDLINE Link]. [Full Text].
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Media Gallery

Large spider angioma on the left cheek of a child.
The spider angioma has been compressed and is refilling rapidly from the central vessel.
A spider nevus consists of a central arteriole with radiating thin-walled vessels. Compression of the central vessel produces blanching and temporarily obliterates the lesion. When released, the threadlike vessels quickly refill with blood from the central arteriole. The ascending central arteriole resembles a spider's body, and the radiating fine vessels resemble multiple spider legs.
Multiple spider angiomas in a patient with cirrhosis.

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Author

Sarah Sweeney Pinney, MD, FAAD Dermatologist, Clear Dermatology

Sarah Sweeney Pinney, MD, FAAD is a member of the following medical societies: American Academy of Dermatology, Texas Dermatological Society, Texas Medical Association, Women's Dermatologic Society

Disclosure: Nothing to disclose.

Coauthor(s)

Ronald P Rapini, MD Professor and Chair, Department of Dermatology, The University of Texas MD Anderson Cancer Center; Distinguished Chernosky Professor and Chair of Dermatology, Professor of Pathology, University of Texas McGovern Medical School at Houston

Ronald P Rapini, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, American Society of Dermatopathology, Association of Professors of Dermatology, Society for Investigative Dermatology, Texas Dermatological Society

Disclosure: Book royalties from Elsevier publishers.

Specialty Editor Board

Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey J Miller, MD Associate Professor of Dermatology, Pennsylvania State University College of Medicine; Staff Dermatologist, Pennsylvania State Milton S Hershey Medical Center

Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Society for Investigative Dermatology, Association of Professors of Dermatology, North American Hair Research Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Carrie L Kovarik, MD Assistant Professor of Dermatology, Dermatopathology, and Infectious Diseases, University of Pennsylvania School of Medicine

Carrie L Kovarik, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Mark Crowe, MD, to the development and writing of this article.

Nevus Araneus (Spider Nevus) Differential Diagnoses

Diagnostic Considerations

Differential Diagnoses

References

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