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Pregnancy and Skin Disease
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Tugba Kevser Uzuncakmak, Ozge Askin, Yalçın Tüzün
Spider angioma and telangiectasias can develop and increase in number due to the high estrogen levels. These lesions are more common in fair-skinned individuals. Preexisting hemangiomas, subcutaneous hemangioendothelioma, glomangiomas, petechiae, and purpura may worsen with pregnancy. Although routine treatment is not required for such lesions, elective cryo-therapy, electrocauterization, and vascular laser treatment are alternatives if only for aesthetic purposes.
Dermatologic diseases and pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Holly Edmonds, Dana Ward, Ann G. Martin, Susana Leal-Khouri
A spider angioma is a bright red macule or papule, with a telangiectatic puncta, radiating branches, and surrounding erythema, easily blanchable with pressure. Spider angiomas appear most commonly in areas drained by the superior vena cava (neck, throat, periorbital, and arms) (28). These changes appear in 67% of white and 11% of black women between the 2nd and 5th months of pregnancy and regress within 3 months postpartum in 75% of cases (29). Persistent spider angiomas may be best treated for cosmetic purposes with electrodesiccation or vascular lasers (28). Treatment is usually deferred until after delivery.
Is this capillary malformation? Differential diagnosis and other dermal vascular lesions
Published in Byung-Boong Lee, Peter Gloviczki, Francine Blei, Jovan N. Markovic, Vascular Malformations, 2019
Localized essential telangiectasia (ET) can be confused with a segmental or mosaic CM (Figure 86.11a and b). Spider angiomas (nevi) are dilated ascending arterioles that present with a central arteriole and plethora of radiating thin-walled vessels (Figure 86.12). When spider angiomas are large, they acquire a patch morphology that may be confused with a CM. Despite the patch morphology, the central arteriole(s) remain a prominent feature of spider angiomas. Dermoscopy, and if not available the application of a glass slide to the lesion, would reveal the central arteriole(s) that will continue to appear pulsatile despite the pressure applied by the glass slide.
Recognizing skin conditions in patients with cirrhosis: a narrative review
Published in Annals of Medicine, 2022
Ying Liu, Yunyu Zhao, Xu Gao, Jiashu Liu, Fanpu Ji, Yao-Chun Hsu, Zhengxiao Li, Mindie H. Nguyen
Spider angioma (Figure 1(b)) is a small telangiectatic lesion consisting of a central arteriole from which capillaries radiate peripherally [12]. This entity occurs in 10–15% of healthy individuals, especially adolescents, pregnant women and women who use oestrogen for contraception. However, when multiple spider angiomas appear, they may be a skin manifestation of liver disease, especially alcoholic cirrhosis and hepatopulmonary syndrome [13,14]. Approximately 33% of patients with liver cirrhosis have spider angiomas [15]. Spider angiomas usually range from a few millimetres to a few centimetres in diameter. These lesions are commonly observed in the area of the superior vena cava above the line joining the nipples [13,15]. Spider angiomas localized on the nose (Figure 1(c)) should be differentiated from erythematotelangiectatic rosacea (ETTR). In contrast to painless spider angiomas, ETTR leads to sensitive skin prone to irritation upon contact with skin care products [16].
Valproic acid induced acute liver injury resulting in hepatic encephalopathy- a case report and literature review
Published in Journal of Community Hospital Internal Medicine Perspectives, 2018
Vijay Gayam, Amrendra Kumar Mandal, Mazin Khalid, Binav Shrestha, Pavani Garlapati, Mowyad Khalid
Vitals signs at presentation included a temperature of 98.2 degrees Fahrenheit, blood pressure of 117/82 mmHg, heart rate of 70 beats per minute and a respiratory rate of 20 beats per minute. The physical examination was notable for somnolence with ataxic gait, scleral icterus, and prominent asterixis. There was no lymphadenopathy, organomegaly, palmar erythema, gynecomastia, shifting dullness, or spider angioma. Kernig’s and Brudzinski’s signs were negative. Remarkable labs included an aspartate aminotransferase (AST) level of 12,000 IU/L (8–48 IU/L), alanine aminotransferase (ALT) of 7,000 IU/L (7–55 IU/L), ammonia of 184µmol/L (15–45 µmol/L), an alkaline phosphatase (ALP) of 96 IU/L (45–115 IU/L) and total bilirubin of 1.5 mg/dL (0.1–1.2 mg/dL). The patient had thrombocytopenia of 87,000 µL (150 to 450 µL) and coagulopathy with INR 2.40. Abdominal ultrasound and computed tomography of the head were both unremarkable. All viral hepatitis serology and toxicology panel including acetaminophen were negative except for a blood ethyl alcohol level of 9 mg/dl (0–5 mg/dl); which was also reflected in urine toxicology with the absence of other commonly tested substances.