Blanching Spider Angioma (Nevus) on Physical Exam



Spider angiomas are usually benign but often can be suggestive of an underlying systemic disease such as cirrhosis, rheumatoid arthritis, or thyrotoxicosis. Solitary spider angiomas are seen in 15% of young adults who usually have fewer than 3 lesions.



A spider angioma is a vascular lesion characterized by anomalous dilatation of end vasculature found just beneath the skin surface. The lesion contains a central, red spot and reddish extensions which radiate outward like a spider's web. They may appear as multiple or solitary lesions.



A spider angioma has 3 features: a body, legs, and surrounding erythema. The body appears as a 1 to 10 mm central arteriole visible as a punctum or eminence. It is typically painless, resembles a spider's body, and is surrounded by attenuated capillaries radiating in a spider-legged fashion, decreasing in size toward the margins.



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