Telangiectasias , also known as spider vessels , are small dilated blood vessels near the surface of the skin or mucous membranes, measuring between 0.5 and 1 millimeter in diameter.
This widening blood vessel can develop anywhere in the body but is usually visible on the face around the nose, cheeks, and chin. The widening blood vessels may also develop in the legs, although when they occur in the legs, they often have underlying venous reflux or "hidden varicose veins" (see "Veins reflux" below). When found on the feet, they are found specifically in the upper thighs, under the knee joint, and around the ankles.
Many patients who suffer with spider veins seek the help of doctors who specialize in the treatment of blood vessels or peripheral vascular disease. These doctors are called vascular surgeons or phlebologists. More recently, interventional radiologists have begun dealing with venous problems.
Some telangiectasis is due to developmental abnormalities that can be very similar to the behavior of benign vascular neoplasms. They may consist of abnormal aggregations of arterioles, capillaries, or venules. Because telangiectasis is a vascular lesion, they blanch when tested with diascopy.
Telangiectasia is a component of the CREST variant of scleroderma, also known today as limited scleroderma (CREST is an acronym that stands for calcinosis, Raynaud's phenomenon, esophageal dismotility, sclerodactyly, and telangiectasia).
Video Telangiectasia
Cause
The cause of telangiectasia can be divided into innate and acquired factors.
Congenital causes
Goldman states that "many inherited or congenital conditions indicate skin telangiectasia". These include:
- Bloom syndrome (homozygous null mutation in BLM DNA repair enzyme, similar mechanism & ampi etiology against telangiectasia ataxia.)
- Naevus flammeus (port-wine stain)
- Klippel-Trenaunay syndrome
- Maffucci syndrome (multiple enchondromas & amp; hemangioma)
- Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome)
- Ataxia-telangiectasia
- Sturge-Weber syndrome, the formation of nevus in the skin supplied by the trigeminal nerve and associated with facial port-wine stains, glaucoma, meningeal angioma and mental retardation
- Hypotrichosis-lymphedema-telangiectasia syndrome, caused by mutations in the transcription factor SOX18
Acquired causes
- Cushing's Syndrome
Venous hypertension
In the past, people used to think that varicose veins or telangectasia are caused by high venous pressure or "venous hypertension". But it is now understood that venous reflux disease is usually the cause of this problem (see above for reference to "venous reflux".
Telangiectasia of the feet is often associated with venous reflux in the underlying varicose veins. Abnormalities of flow in the mid-sized veins of the limbs (reticular veins) may also lead to the development of telangiectasia. Factors affecting the development of varicose veins and telangiectatic leg veins include
- Age: The development of spider veins can occur at any age but usually between 18 and 35 years, and peaks between 50 and 60 years.
- Gender: It used to be thought that women were affected much more than men. But the study showed 79% of adult men and 88% of adult women had telangectasia of the foot (spider veins).
- Pregnancy: Pregnancy is a key factor contributing to the formation of varicose veins and veins. The most important factor is the circulating hormone that weakens the walls of the blood vessels. There is also a significant increase in blood volume during pregnancy, which tends to shrink the blood vessels, causing valvular dysfunction that causes the union of blood in the blood vessels. In addition, later in pregnancy, the enlarging uterus may compress the veins, causing higher venous pressure to cause the veins to dilate. Varicose veins that form during pregnancy can spontaneously improve or even disappear several months after delivery.
- Lifestyle/occupation: Those who are engaged with long sitting or standing in their daily activities have an increased risk of developing varicose veins. The weight of the blood continuously suppresses the closed valve causing them to fail, causing the distention vein.
Other causes obtained
Acquired telangiectasia, unrelated to other venous disorders, such as on the face and torso, may be caused by factors such as
- Acne rosacea
- Blepharitis
- Environmental damage such as those caused by sunlight or cold exposure
- Age
- Trauma to the skin such as contusions or surgical incisions.
- Exposure to radiation as experienced during radiotherapy for cancer treatment
- Chemotherapy
- Carcinoid syndrome
- Systemic sclerosis/scleroderma is limited (sub-type Scleroderma)
- Chronic treatment with topical corticosteroids can cause telangiectasia.
- Spider angiomas are small arterial radial arrays that usually occur in pregnant women and in patients with cirrhosis of the liver and are associated with palmar erythema. In men, they are associated with high levels of estrogen due to liver disease.
- Pages syndrome
- Smoking
Maps Telangiectasia
Treatment
Prior to the treatment of telangectasia feet (spider veins) considered, it is important to have duplex ultrasonography, a test that has replaced Doppler ultrasound. The reason for this is that there is a clear link between the telangectasia of the foot (spider veins) and the basic venous reflux. Studies have shown that 88-89% of women with telangectasia (spider veins) experience close reticular venous reflux, and 15% have incompetent perforator veins nearby. Therefore, it is important to find and treat basic vein reflux before considering any treatment.
Sclerotherapy is a "gold standard" and is preferred over lasers to eliminate telangiectasiae and smaller varicose veins. The sclerosant drug is injected into the sick veins so that it hardens and eventually shrinks. Recent evidence with foam sclerotherapy suggests that an annoying sclerosant-containing foam quickly appears in the patient's heart and lungs, and then in some cases travels through the patent foramen ovale to the brain. This has caused concerns about the security of sclerotherapy for telangectasias and spider veins.
In some cases stroke and transient ischemic attacks occur after sclerotherapy. Varicose veins and reticular veins are often treated before treating telangiectasia, although larger vein treatments before sclerotherapy for telangiectasia may not guarantee better results. Varicose veins can be treated with foam sclerotherapy, endovenous laser treatment, radio frequency ablation, or open surgery. The greatest risk, however, seems to occur with sclerotherapy, particularly in terms of systemic risk of DVT, pulmonary embolism, and stroke.
Other problems that arise with the use of sclerotherapy to treat varicose veins are dyeing, shadowing, telangetatic matting, and ulceration. In addition, incomplete therapy is common, requiring several treatment sessions.
Telangiectasias on the face are often treated with lasers. Laser therapy uses pulsed light to the veins to seal it, causing them to dissolve. This light-based treatment requires adequate venous heating. This treatment can lead to the destruction of the sweat glands, and the risk increases with the number of treatments.
In popular culture
Apart from these conditions that are somewhat common in English speaking population populations, it is almost unknown in popular culture. Mentioned (like t Langiatasis , when spoken) as "a condition that anyone can get" in Wodehouse Playhouse Series 1: "Romance at Droitgate" (Spa) 30 April 1975.
References
External links
Source of the article : Wikipedia
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