Approach Considerations
Individual case reports have described unilateral nevoid telangiectasia in association with other systemic abnormalities. Such associations include cases associated with hormonal disturbances and hepatic dysfunction. Case reports have described an association with hyperthyroidism [12, 13] and a case of unilateral nevoid telangiectasia occurring in a hepatitis B carrier without evidence of liver dysfunction.
Tanglertsampan et al reviewed the literature and found multiple case reports of unilateral nevoid telangiectasia, some of which were associated with other diseases. [13] It is not clear if these are coincidental or not. The authors proposed a new classification system, in which acquired cases may be divided into cases with an association and cases without. Associated conditions included estrogen-related (pregnancy, puberty in women), liver-related (cirrhosis, hepatitis C, hepatitis B), skin-related (possibly pyogenic granuloma), and others (including hyperthyroidism).
Kucuk et al presented the case of a healthy 26-year-old male patient diagnosed with unilateral nevoid telangiectasia, present since childhood. The authors caution that signs of hyperestrogenism must be ruled out in male patients with unilateral nevoid telangiectasia symptoms. [14]
Other Tests
Punch biopsy of lesional and perilesional skin for comparison may be considered. Skin biopsy is usually not necessary because the diagnosis is usually established on clinical grounds.
Other testing is not necessary. However, Kreft et al have described the results of laser-Doppler flowmetry in a patient with unilateral nevoid telangiectasia. [15] They were able to demonstrate increased perfusion in areas of unilateral nevoid telangiectasia, even in areas that were clinically unremarkable. They also found that capillary microscopy demonstrated morphologically altered capillaries.
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Unilateral nevoid telangiectasia on the neck.
