Skin Vascular Lesions

Question 1

Vascular Tumours

Definition

Answer 1

Endothelial hyperplasia

Question 2

Vascular Tumours

Presence at Birth

Answer 2

Usually postnatal

Question 3

Vascular Tumours

M:F

Answer 3

1:3-5

Question 4

Vascular Tumours

Natural History

Answer 4

Phases
Proliferating
Involuting
Involuted

Question 5

Vascular Malformations

Definition

Answer 5

Congenital malformation with normal endothelial turnover

Question 6

Vascular Malformations

Presence at Birth

Answer 6

100% at birth (not always obvious)

Question 7

Vascular Malformations

M:F

Answer 7

1:1

Question 8

Vascular Malformations

Natural History

Answer 8

Proportionate growth (can expand)

Question 9

HEMANGIOMAS

Clinical Feature

Answer 9

• red or blue subcutaneous mass that is soft/compressible, blanches with pressure; feels like a “bag of
worms” when palpated

Question 10

HEMANGIOMAS

Pathophysiology

Answer 10

• benign vascular tumour

* includes: cavernous hemangioma, capillary/infantile hemangioma, spider hemangioma

Question 11

Does spider angioma blanch?

Answer 11

A spider angioma will blanch when the tip
of a paperclip is applied to the centre of
the lesion

Question 12

Hot, firm red to blue plaques or

tumours

Answer 12

Hemangioma of

Infancy

Question 13

Hemangioma of
Infancy
Pathophysiology

Answer 13

Benign vascular
proliferation of endothelial
lining

Question 14

Hemangioma of
Infancy
Epidemiology

Answer 14

Appears shortly
after birth;
rarely may be
congenital

Question 15

Hemangioma of
Infancy
Clinical Course

Answer 15

Appears shortly after
birth, increases in size
over months, then
regresses
50% of lesions resolve
spontaneously by 5 yr

Question 16

Hemangioma of
Infancy
Management

Answer 16

10% require treatment due to functional
impairment (visual compromise, airway
obstruction, high output cardiac failure) or
cosmesis
Consider treatment if not gone by school
age; topical timolol, propranolol; systemic
corticosteroids; laser treatment; surgery
Provide early specialist referral or
treatment in infants with high-risk
hemangiomas

Question 17

Central red arteriole with slender

branches, blanchable

Answer 17

Spider Angioma

Question 18

Spider Angioma Synonym

Answer 18

(Campbell

Telangiectasia)

Question 19

Spider Angioma

Pathophysiology

Answer 19

Can be associated with
hyperestrogenic state (e.g.
in liver disease, pregnancy,
OCP) but more often is not

Question 20

Spider Angioma

Epidemiology

Answer 20

Any age

Question 21

Spider Angioma

Clinical Course

Answer 21

Increase in number

over time

Question 22

Spider Angioma

Management

Answer 22

Reassurance
Electrodesiccation or laser surgery if
patient wishes

Question 23

Bright red to deep maroon, domeshaped
vascular papules, 1-5 mm
Site: trunk
Less friable compared to

Answer 23

Cherry Angioma

Question 24

synonym of Cherry Angioma

Answer 24

(Campbell De

Morgan Spot)

Question 25

Cherry Angioma | Pathophysiology

Answer 25

Benign vascular neoplasm

Question 26

Cherry Angioma | Epidemiology

Answer 26

>30 yr old

Question 27

Cherry Angioma | Clinical Course

Answer 27

Lesions do not fade in time Lesions bleed infrequently

Question 28

Cherry Angioma | Management

Answer 28

Usually no treatment needed Laser or electrocautery for small lesions Excision of large lesions if necessary

Question 29

Bright red, dome-shaped sessile or pedunculated friable nodule Sites: fingers, lips, mouth, trunk, toes

Answer 29

Pyogenic | Granuloma

Question 30

Pyogenic Granuloma Pathophysiology

Answer 30

``` Rapidly developing hemangioma Proliferation of capillaries with erosion of epidermis and neutrophilia ```

Question 31

Pyogenic Granuloma Epidemiology

Answer 31

<30 yr old

Question 32

Pyogenic Granuloma Clinical Course

Answer 32

``` Lesion grows rapidly over wk-mo, then stabilizes Lesion may persist indefinitely if untreated ```

Question 33

Pyogenic Granuloma Management

Answer 33

Surgical excision with histologic examination Electrocautery; laser; cryotherapy

Question 34

blue or violaceous papular lesion occurring on the face, lips, and ears

Answer 34

Venous Lake: benign blue or violaceous papular lesion occurring on the face, lips, and ears due to dilation of a venule.

Question 35

Venous Lake DDx

Answer 35

Distinguished from malignant pigmented lesions through diascopy, as compression blanches the lesion

Question 36

Red to blue macule present at birth that follows a | dermatomal distribution, rarely crosses midline

Answer 36

Nevus Flammeus

Question 37

Nevus Flammeus synonym

Answer 37

(Port-wine stain)

Question 38

Nevus Flammeus | Clinical Feature, site and course

Answer 38

Red to blue macule present at birth that follows a dermatomal distribution, rarely crosses midline Most common site: nape of neck Never spontaneously regresses but grows in proportion to the child

Question 39

Nevus Flammeus | Pathophysiology

Answer 39

``` Congenital vascular malformation of dermal capillaries; rarely associated with Sturge-Weber syndrome (V1, V2 distribution) ```

Question 40

Nevus Flammeus | Management

Answer 40

Laser or make-up

Question 41

Pink-red irregular patches Midline macule on glabella, | or nuchal region, on newborns

Answer 41

Nevus Simplex

Question 42

Nevus Simplex synonym

Answer 42

(salmon patch)

Question 43

Nevus Simplex | Clinical Feature, site and course

Answer 43

``` Pink-red irregular patches Midline macule on glabella known as “Angel Kiss”; on nuchal region known as “Stork Bites” Present in 1/3 of newborns Majority regress spontaneously ```

Question 44

Nevus Simplex | Pathophysiology

Answer 44

Congenital dilation of dermal | capillaries

Question 45

Nevus Simplex | Management

Answer 45

No treatment | required