Spider angioma

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Articles on Spider angioma in N Eng J Med, Lancet, BMJ

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Evidence Based Medicine

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Clinical Trials

Ongoing Trials on Spider angioma at Clinical Trials.gov

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Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Spider angioma

NICE Guidance on Spider angioma

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Definitions

Definitions of Spider angioma

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Risk calculators and risk factors for Spider angioma

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Symptoms of Spider angioma

Causes & Risk Factors for Spider angioma

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Historical Perspective

  • [Disease name] was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].
  • In [year], [gene] mutations were first identified in the pathogenesis of [disease name].
  • In [year], the first [discovery] was developed by [scientist] to treat/diagnose [disease name].

Classification

  • [Disease name] may be classified according to [classification method] into [number] subtypes/groups:
  • [group1]
  • [group2]
  • [group3]
  • Other variants of [disease name] include [disease subtype 1], [disease subtype 2], and [disease subtype 3].

Pathophysiology

  • The pathogenesis of [disease name] is characterized by [feature1], [feature2], and [feature3].
  • The [gene name] gene/Mutation in [gene name] has been associated with the development of [disease name], involving the [molecular pathway] pathway.
  • On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
  • On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Causes

Disease name] may be caused by [cause1], [cause2], or [cause3].

OR

Common causes of [disease] include [cause1], [cause2], and [cause3].

OR

The most common cause of [disease name] is [cause 1]. Less common causes of [disease name] include [cause 2], [cause 3], and [cause 4].

OR

The cause of [disease name] has not been identified. To review risk factors for the development of [disease name], click here.

Differentiating [disease name] from other Diseases

  • [Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
  • [Differential dx1]
  • [Differential dx2]
  • [Differential dx3]

Epidemiology and Demographics

  • The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.[1]
  • In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].

Age

  • Patients of all age groups may develop [disease name].
  • [Disease name] is more commonly observed among patients aged [age range] years old.
  • [Disease name] is more commonly observed among [elderly patients/young patients/children].

Gender

  • There is no documented study showing gender predilection for Spider Angioma in otherwise healthy population.
  • However there is an increased incidence in pregnant women, which

Race

  • There is no racial predilection for Spider Angiomas, but can have more visibility in light skinned people.

Risk Factors

  • Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].

Natural History, Complications and Prognosis

  • The majority of patients with [disease name] remain asymptomatic for [duration/years].
  • Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
  • If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
  • Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
  • Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with [disease name] is approximately [#%].

Diagnosis

Diagnostic Criteria

  • The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
  • [criterion 1]
  • [criterion 2]
  • [criterion 3]
  • [criterion 4]

History and Symptoms

  • [Disease name] is usually asymptomatic.
  • Symptoms of [disease name] may include the following:
  • [symptom 1]
  • [symptom 2]
  • [symptom 3]
  • [symptom 4]
  • [symptom 5]
  • [symptom 6]

Physical Examination

  • Patients with [disease name] usually appear [general appearance].
  • Spider angiomas are usually present on face, chest and arms in the distribution of Superior Vena Cava. But unusual presentations on Palpebra has been reported[2].
  • Physical examination may be remarkable for:
  • [finding 1]
  • [finding 2]
  • [finding 3]
  • [finding 4]
  • [finding 5]
  • [finding 6]

Laboratory Findings

  • There are no specific laboratory findings associated with [disease name].
  • A [positive/negative] [test name] is diagnostic of [disease name].
  • An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
  • Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Electrocardiogram

There are no ECG findings associated with Spider angiomas.

X-ray

There are no x-ray findings associated with Spider angiomas.

Echocardiography or Ultrasound

  • There are no echocardiography/ultrasound findings associated with Spider angiomas as such.
  • Ultrasound may be helpful in the identifying the underlying liver cirrhosis with a high positive predictive value[3].

CT scan

  • There are no CT scan findings associated with Spider angiomas.
  • CT scan is the most sensitive imaging modality for identifying the underlying liver cirrhosis[4].

MRI

  • There are no MRI findings associated with Spider angiomas.

Other Imaging Findings

  • There are no other imaging findings associated with Spider angiomas.

Other Diagnostic Studies

Biopsy may be helpful in the diagnosis of Spider angioma when the presentation isn't classical. Findings diagnostic of spider angioma include Cutaneous arterial net, Central spider arteriole, Subepidermal ampulla , Star shaped arrangement of efferent spider vessels, and Capillaries.

OR

Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

  • There is no treatment for [disease name]; the mainstay of therapy is supportive care.
  • The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
  • [Medical therapy 1] acts by [mechanism of action 1].
  • Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].

Surgery

  • Surgery is the mainstay of therapy for [disease name].
  • [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
  • [Surgical procedure] can only be performed for patients with [disease stage] [disease name].

Prevention

  • There are no primary preventive measures available for [disease name].
  • Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
  • Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].

References

  1. Yigider, Ayse Pelin; Kayhan, Fatma Tulin; Yigit, Ozgur; Kavak, Ayse; Cingi, Cemal (2016). "Skin Diseases of the Nose". American Journal of Rhinology & Allergy. 30 (3): e83–e90. doi:10.2500/ajra.2016.30.4318. ISSN 1945-8924.
  2. Yalcin K, Ekin N, Atay A (2013). "Unusual presentations of spider angiomas". Liver Int. 33 (3): 487. doi:10.1111/liv.12009. PMID 23121469.
  3. Viganò M, Visentin S, Aghemo A, Rumi MG, Ronchi G (2005). "US features of liver surface nodularity as a predictor of severe fibrosis in chronic hepatitis C." Radiology. 234 (2): 641, author reply 641. doi:10.1148/radiol.2342041267. PMID 15671013.
  4. Kudo M, Zheng RQ, Kim SR, Okabe Y, Osaki Y, Iijima H; et al. (2008). "Diagnostic accuracy of imaging for liver cirrhosis compared to histologically proven liver cirrhosis. A multicenter collaborative study". Intervirology. 51 Suppl 1: 17–26. doi:10.1159/000122595. PMID 18544944.

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