Unilateral Nevoid Telangiectasia Clinical Presentation

Updated: Mar 09, 2017
  • Author: Rajani Katta, MD; Chief Editor: Dirk M Elston, MD  more...
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Presentation

History

Cutaneous lesions are asymptomatic and may go unrecognized. Inquiry into possible stimulus for development may include relation to puberty, pregnancy, contraceptive use, or hepatic diseases.

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Physical Examination

Patches of superficial, blanchable telangiectasias may be small to large and few to numerous. They are disposed predominantly in a unilateral linear distribution. Note the image below.

Unilateral nevoid telangiectasia on the neck. Unilateral nevoid telangiectasia on the neck.

The third and fourth cervical dermatomes are the most common sites, but the thoracic dermatomes and scattered distant sites may also be involved.

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Causes

The pathogenesis of unilateral nevoid telangiectasia remains unknown.

The occurrence of acquired unilateral nevoid telangiectasia in certain settings characterized by elevations of estrogen suggests hormonal causes. Such settings include puberty, pregnancy, and during oral contraceptive use. The other major setting in which this has been reported to occur is in states of hepatic dysfunction. Unilateral nevoid telangiectasia has been reported in patients with chronic liver disease due to alcoholism or hepatitis C, as well as liver metastases from carcinoid tumor [5]  and colon cancer.  [6]

Uhlin et al documented increased levels of estrogen and progesterone receptors in involved areas compared with normal skin [7] ; however, other reports have not been able to reproduce this finding.

Because unilateral nevoid telangiectasia has been noted in cases in which no underlying hormonal or hepatic pathology has been found, other mechanisms probably play a role in the pathogenesis.

Although reported cases often involve a dermatome or a group of dermatomes, distribution following the lines of Blaschko suggests that a postzygotic somatic mutation leads to a distinct cell population in the affected site (mosaicism).

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