Telangiectasia

Key Points
Condition results in small red markings on the skin, often the face or lower extremities, resulting from permanent dilation of small blood vessels.

Usually symptomless, sometimes accompanied by tingling and numbness, and skin tends to go white before slowly filling back in with red when pressure is applied.

Cause is multifactorial including sun damage(face and neck), hormonal changes(chest and extremities), and gravity(legs). Frequently occurs in women over the age of 40.
Condition is benign with no physical complications, other than possibly emotional distress at the red markings.

If telangiectasia are multiple, involove the mucous membranes, and are associated with nosebleeds, then hereditary hemorrhagic telangiectasia(HHT) should be considered. A rare genetic disorder.

Telangiectasia is a condition describing the permanent dilation of small blood vessels, creating small red markings on the skin. There are many different versions of telangiactasia. Essential, or primary telangiectasia concerns the dilation coming from an unknown origin, because no preceding or coexisting disease — skin or other kinds — are present. Generalized essential telangiectasia refers to telangiectasia that appears all over the body. Other primary telangiectases include angioma serpiginosum, ataxia-telangiectasia, angiomas and spider naevi.

Generalized essential telangiectasia is characterized by red or pink dilated capillary blood vessels in a lacework or branch-like pattern, marks appearing most often on the feet, ankles and lower legs but can appear on the trunk and upper body parts,. Occasionally several telangiectases join together to form a widespread red patch. When pressure is placed on the affected sites, the skin may go white before blood refills the red patches. Usually Telangiectasia is symptomless but tingling and numbness occasionally accompanies the redness and marking.

The cause of telangiectasia remains unclear. Sometimes there may be a family history. It usually first appears around 40-50 years of age and affects women more often than men. It is not associated with varicose veins or other disorders of the veins. Environmental factors such as sun exposure may possibly play a part in its development.

Telangiectases may be slow or fast to develop and usually spread to other parts of the body. They persist indefinitely and do not spontaneously resolve. Apart from possible emotional distress, generalised essential telangiectasia is a benign condition that is not associated with any physical complications.

Differential Diagnosis (Other conditions with similar appearance)

Angiokeratoma Corporis Diffusum (Fabry Syndrome), Hereditary hemmorhagic telangiectasia

Diagnosis
Key Points
Diagnosis is determined through clinical inspection to resolve possible differential diagnosis.

Diagnosis is determined through clinical inspection to resolve possible differential diagnosis.

Treatment
Key Points
Telangiectases are difficult to remove.
Patients may use cosmetics or lotions to hide the markings.
*Vascular lasers have shown possible improvement of the condition.

It is very difficult to remove the telangiectases of generalized essential telangiectasia. Patients may use cover-up cosmetics or self-tanning lotions to hide the telangiectases.

They are usually unresponsive to sclerotherapy. Recently, various vascular lasers (frequency-doubled Nd-YAG, copper bromide and pulse-dye lasers) have shown promise in the treatment of generalized essential telangiectasia.