Angiomas are tumor of the blood vessels. The 2 angiomas that are commonly seen include
- Strawberry angioma (infantile) see in infants
- Cherry Angioma (senile angioma) seen in elderly
Strawberry angioma are benign angioma found in infant that often regress spontaneous eventually by 5 years old. They may persist sometimes but are only treated for cosmetic purposes or if there is any anatomical or functional interference.
Senile angioma or Cherry angioma (Campbell de Morgan spots) are benign angioma that are commonly see in elderly especially those with fair complexion. They are mature capillary proliferations that are common in middle-aged and older adult patients
- Cherry angiomas are also known as Campbell de Morgan spots, are mature capillary proliferations that are common in middle-aged and older adult
- Usually multiple lesions, most commonly on the trunk (bleed profusely with any traumatic rupture).
- Usually dome-shaped, typically 1 to 0.4 cm in diameter, and always blanch with pressure (although some are more fibrotic and may not blanch completely).
Causes and Risk Factors
- The cause of angioma is unknown but there is a genetic component to it.
Presentation and Diagnosis of Cherry angioma
- Clinically diagnosed based on appearance of lesion. They typically occur as multiple lesions usually occurring on the trunk and often bleed profusely when they rupture from trauma.
- Examination with a dermatoscope typically show characteristic red/purple or blue-black lagoons.
- Cherry angiomas may be confused with other malignant lesions like amelanotic melanomas. Amelanotic melanoma usually have more friable looking lesion with a recently changed in size or appearance.
- Lesion should be excised if there is concern for malignancy.
Treatment of Cherry Angioma
- Usually cosmetic reasons but the chance of recurrence post treatment are likely. There is no guarantee that these lesion will not recur and there is no effective way to prevent cherry angioma from developing.
- Small lesions: electrocauterization post anesthesia with 1% lidocaine without epinephrine for small lesion due to risk of obscure of lesion by epinephrine vasoconstriction.
- Large lesions: Shaved excision plus electrocauterization of base
- Pulsed dye vascular laser therapy can be used to remove superficial lesions in isolated cases or for cosmetic reasons.
- This is one of the most common benign tumors of infancy and occurs in approximately 5% – 10% of infants. They are benign vascular tumors composed of an increased number of unique endothelial cells that line blood vessels.
Cause and Risk factors
- They are more frequently in female, premature and low birth weight infants.
Symptoms and Clinical Presentation
- Usually appear within the first weeks of life and grow most rapidly during the first 3 to 6 months of life.
- 80% of infantile hemangioma size is generally reached by 3 months of age.
- Usually, growth and proliferation is complete and involution commences by 12 months of age, however, sometimes involution occurs slowly over many years with a most of them having regression occurring by 5 years of age.
Treatment and Management
- No treatment is necessary unless there is residual left, involve organs, obscure normal function and at risk of bleeding. Clinically differentiate the to complicated vs uncomplicated infantile hemangioma
- Medications include (first line: beta blockers such as timolol, propranolol; others include Intralesional steroid, Imiquimod)