Abstract
Spider angioma refers to a type of telangiectasis that presents slightly beneath the
skin surface on the face, neck, arms or upper trunk, often manifesting with a central
red spot and reddish extensions that radiate outwards like a spider's web. The cutaneous
spider angioma may be benign but it often indicates abnormal liver function, especially
in patients with chronic cirrhosis. The spider angioma is irreversible and rarely
occurred diffusely over the body or with giant sizes. Here, we report two rare multiple
and giant spider angioma cases in patients with HIV/AIDS who developed chronic cirrhosis.
In addition, we comprehensively reviewed related literatures and evaluated the existing
possible mechanisms of spider angioma.
Key Indexing Terms
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of the Medical SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
Samant H, Kothadia JP. Spider Angioma. Treasure Island, FL: StatPearls Publishing; 2020.
- Spider naevi.Br J Hosp Med (Lond). 2013; 74: C86-C88
- Images in clinical medicine. Spider angioma.N Engl J Med. 2012; 366: e13https://doi.org/10.1056/NEJMicm1109272
- Spider angiomas in patients with liver cirrhosis: role of alcoholism and impaired liver function.Scand J Gastroenterol. 1999; 34: 520-523https://doi.org/10.1080/003655299750026272
- Pulmonary hypertrophic osteoarthropathy, spider angiomata, and estrogen hyperexcretion in neoplasia.Ann Intern Med. 1969; 70: 581-584https://doi.org/10.7326/0003-4819-70-3-581
- Estrogen inunction and spider telangiectasia in liver disease.Am J Med Sci. 1954; 227: 657-660https://doi.org/10.1097/00000441-195406000-00009
- Cutaneous signs of liver disease: value for prognosis of severe fibrosis and cirrhosis.Liver Int Off J Int Assoc Study Liver. 2008; 28: 659-666https://doi.org/10.1111/j.1478-3231.2008.01694.x
- Spider nevi and chronic liver disease.Indian J Dermatol Venereol Leprol. 2009; 75: 403https://doi.org/10.4103/0378-6323.53141
- Dermatologic disorders and the liver.Clin Liver Dis. 2011; 15: 165-182https://doi.org/10.1016/j.cld.2010.09.001
- Liver cirrhosis.Lancet. 2014; 383: 1749-1761https://doi.org/10.1016/S0140-6736(14)60121-5
- [Physiological cutaneous signs in normal pregnancy: a study of 60 pregnant women].Ann Dermatol Venereol. 1994; 121 (Signes cutanes physiologiques au cours de la grossesse normale: etude de 60 femmes enceintes): 227-231
- Diagnosis and epidemiology of cirrhosis.Med Clin North Am. 2009; 93: 787-799https://doi.org/10.1016/j.mcna.2009.03.002
- Spider nevi: a presenting feature of chronic liver disease.Indian J Dermatol Venereol Leprol. 2008; 74: 397-398https://doi.org/10.4103/0378-6323.42921
- Impact of spider nevus and subcutaneous collateral vessel of chest/abdominal wall on outcomes of liver cirrhosis.Arch Med Sci AMS. 2019; 15: 434-448https://doi.org/10.5114/aoms.2018.74788
- Sublingual microcirculatory alterations in cirrhotic patients.Microcirculation. 2018; 25 (New York, NY: 1994): e12448https://doi.org/10.1111/micc.12448
- Spider angiomas in patients with liver cirrhosis: role of vascular endothelial growth factor and basic fibroblast growth factor.World J Gastroenterol. 2003; 9: 2832-2835https://doi.org/10.3748/wjg.v9.i12.2832
- Mucocutaneous spider angiomas in an adolescent with chronic liver disease.Arch Dis Child. 2018; 103: 1145https://doi.org/10.1136/archdischild-2017-314406
- Are the spider angiomas skin markers of hepatopulmonary syndrome?.Arq Gastroenterol. 2013; 50: 175-179https://doi.org/10.1590/S0004-28032013000200031
- Vascular spider: a cutaneous manifestation of hyperdynamic blood flow in hepatic cirrhosis.South Med J. 1975; 68: 246-248
- Role of substance P in the pathogenesis of spider angiomas in patients with nonalcoholic liver cirrhosis.Am J Gastroenterol. 1999; 94: 502-507https://doi.org/10.1111/j.1572-0241.1999.883_l.x
- Moderate levels of ethanol induce expression of vascular endothelial growth factor and stimulate angiogenesis.Am J Physiol Regul Integr Comp Physiol. 2001; 281: R365-R372https://doi.org/10.1152/ajpregu.2001.281.1.R365
- Vascular endothelial growth factor and angiogenesis.Pharmacol Rev. 2004; 56: 549-580https://doi.org/10.1124/pr.56.4.3
- Clinical significance of microvessel density and vascular endothelial growth factor expression in hepatocellular carcinoma and surrounding liver: possible involvement of vascular endothelial growth factor in the angiogenesis of cirrhotic liver.Hepatology. 1998; 27 (Baltimore, Md).: 1554-1562https://doi.org/10.1002/hep.510270613
- Vasodilator properties of alcohol.Br Med J. 1967; 2: 274-277https://doi.org/10.1136/bmj.2.5547.274
- Alcohol use accelerates HIV disease progression.AIDS Res Hum Retroviruses. 2010; 26: 511-518https://doi.org/10.1089/aid.2009.0211
- Binge drinking's effects on the body.Alcohol Res. 2018; 39: 99-109
- High levels of alcohol consumption increase the risk of advanced hepatic fibrosis in HIV/hepatitis C virus-coinfected patients: a sex-based analysis using transient elastography at enrollment in the HEPAVIH ANRS CO13 cohort.Clin Infect Dis. 2014; 59: 1190-1192https://doi.org/10.1093/cid/ciu525
- Relationship between alcohol use categories and noninvasive markers of advanced hepatic fibrosis in HIV-infected, chronic hepatitis C virus-infected, and uninfected patients.Clin Infect Dis. 2014; 58: 1449-1458https://doi.org/10.1093/cid/ciu097
- Alcoholic liver fibrosis: detection and treatment.Minerva Med. 2018; 109: 457-471https://doi.org/10.23736/S0026-4806.18.05844-5
- Hepatitis C-related cirrhosis. Current status.Med Clin (Barc). Jan 20 2017; 148 (Cirrosis por hepatitis C. Estado actual): 78-85https://doi.org/10.1016/j.medcli.2016.09.019
- Risk factors for syphilis and prevalence of HIV, hepatitis B and C among men who have sex with men in Beijing, China: implications for HIV prevention.AIDS Behav. 2009; 13: 663-670https://doi.org/10.1007/s10461-008-9503-0
- Sexually transmitted coinfections in patients with anogenital warts - a retrospective analysis of 196 patients.J Dtsch Dermatol Ges. 2020; 18: 325-332https://doi.org/10.1111/ddg.14060
- Viral hepatitis in HIV infection.N Engl J Med. 2007; 356: 1445-1454https://doi.org/10.1056/NEJMra065142
- Human immunodeficiency virus and hepatitis C virus coinfection: epidemiology, natural history, therapeutic options and clinical management.Infection. 2004; 32: 33-46https://doi.org/10.1007/s15010-004-3063-7
- High prevalence of HIV-1 and hepatitis C virus coinfection among injection drug users in the southeastern region of Yunnan, China.J Acquir Immune Defic Syndr. 2002; 29: 191-196https://doi.org/10.1097/00042560-200202010-00014
- Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews.Lancet. 13 2011; 378: 571-583https://doi.org/10.1016/S0140-6736(11)61097-0
- Comparison of HIV-, HBV-, HCV- and co-infection prevalence between Chinese and Burmese intravenous drug users of the China-Myanmar border region.PLoS One. 2011; 6: e16349https://doi.org/10.1371/journal.pone.0016349
- Spontaneous viral clearance, viral load, and genotype distribution of hepatitis C virus (HCV) in HIV-infected patients with anti-HCV antibodies in Europe.J Infect Dis. 2008; 198: 1337-1344https://doi.org/10.1086/592171
- HBV, HCV, and HBV/HCV co-infection among HIV-positive patients in Hunan province, China: Regimen selection, hepatotoxicity, and antiretroviral therapy outcome.J Med Virol. 2018; 90: 518-525https://doi.org/10.1002/jmv.24988
- Aromatase in health and disease.Endocrinologist. 2003; 13: 269-276
- Clinical, hormonal, behavioral, and genetic characteristics of androgen insensitivity syndrome in a Brazilian cohort: five novel mutations in the androgen receptor gene.J Clin Endocrinol Metab. 2003; 88: 3241-3250https://doi.org/10.1210/jc.2002-021658
- Gonadal dysfunction in systemic diseases.Eur J Endocrinol. 2005; 152: 501-513https://doi.org/10.1530/eje.1.01886
- Clinical and etiological aspects of gynecomastia in adult males: a multicenter study.Biomed Res Int. 2018; 8364824https://doi.org/10.1155/2018/8364824
- Gynecomastia in HIV-infected patients receiving antiretroviral therapy.AIDS Res Hum Retrovir. 2003; 19: 739-741https://doi.org/10.1089/088922203769232539
- Gynaecomastia in HIV-infected men: association with effects of antiretroviral therapy.Aids. 24 2002; 16: 1193-1195https://doi.org/10.1097/00002030-200205240-00019
- Solitary giant spider angioma with an overlying pyogenic granuloma.J Am Acad Dermatol. 1987; 16: 1053-1054https://doi.org/10.1016/s0190-9622(87)80418-8
- Multiple spider angiomas in a patient with chronic hepatic graft-versus-host disease.Chin Med J (Engl). 2020; : 749-750https://doi.org/10.1097/CM9.0000000000000707
- Giant spider angiomas.Oxf Med Case Reports. 2014; 2014: 55https://doi.org/10.1093/omcr/omu023
- A giant spider nevus in a patient of hepatitis C-related liver cirrhosis: a rare presentation.Int J Appl Basic Med Res. 2015; 5: 206-207https://doi.org/10.4103/2229-516X.165373
- Unusual presentations of spider angiomas.Liver Int. 2013; 33: 487https://doi.org/10.1111/liv.12009
- Extraordinarily large, giant spider angioma in an alcoholic cirrhotic patient.Int J Dermatol. 2014; 53: e119-e121https://doi.org/10.1111/j.1365-4632.2012.05548.x
- Spider nevus.J Postgrad Med. 2002; 48: 307-309
Article info
Publication history
Published online: January 02, 2022
Accepted:
December 20,
2021
Received:
November 13,
2020
Identification
Copyright
© 2022 Published by Elsevier Inc. on behalf of Southern Society for Clinical Investigation.
