DERMATOLOGY > VASCULAR LESIONS
What is an angioma?
An angioma is a reddish superficial injury which is also known as haemangioma. An angioma is formed by small blood vessels grouped together in a sort of conglomerate. They can appear on any area on the surface of the skin, on the mouth, nose, vagina, or anus, they can rarely affect other parts of the body.
Its size can vary from small to lesions that cover a whole leg or arm. Angiomas may appear up in 8% of the kids during their first year of life, but only in 1% after the second year. As most angiomas disappear spontaneously, they are usually rare in adults.
Causes of angioma
The exact cause which originates angiomas is unknown. It is usually claimed that they are caused because of a defect, probably hereditary, on the blood vessels, which do not develop normally. Angiomas, however, are not hereditary.
Types of angiomas
- Haemangiomas (called strawberry or tubular angioma and cavernous angioma).
- Vascular malformations, which include nevus flammeus or salmon stain, and Port-wine stain. Haemangiomas are tumours that are relatively frequent during childhood. They can be located anywhere on the body, but the most frequent areas are the eyes, the nose, the mouth, the genitals, and the anus. They can appear at birth or during the first days of life. If the haemangioma is superficial -the most frequent one- it is known as strawberry or tubular angioma. If it is deep, it is known as cavernous angioma.
- Strawberry angiomas are a bit higher than the skin surrounding them, which is usually softer. They usually measure between 2 and 5 cm in diameter, although sometimes they may be larger. They can grow slowly during the first months of life of the baby. After this growing period, the stabilization period takes place and, after that, the spontaneous regression occurs. The regression is usually very slow. After the regression, the lesion is barely noticeable.
Regression of angiomas takes place at the age of five in 50% of the cases, and at the age of seven in a 70%, approximately.
- The cavernous angioma is the deepest one. The vessels which form it group under the skin in a sort of conglomerate and they give the angioma a bluish appearance. Its edges are irregular. Cavernous angiomas can be of many different sizes, but in general they are not bigger than 6 cm. The skin that covers the angioma can look milky and soft. Cavernous angiomas also have a growing period, a stabilisation period, and a regression period, but the regression in this case can cause a dermoaesthetic problem to the point of considering adding a surgical procedure to the process.
- Port-wine mole: This vascular malformation is uncommon. It is usually red or bluish red, and appears on the face and neck, although sometimes it appears on the mouth, nose, legs, and arms. Its size is variable and it can cover all the face or parts of the body. The Port-wine mole is normally flat and it does not stand out from the surrounding skin. However, it can grow over time and even nodules can appear. Most of these cases are located on the neck and scalp, but when they appear on the face, they can cause a serious dermoaesthetic problem. The use of laser techniques to treat these lesions has largely improved the treatment.
- The nevus flameus or salmon stain is a vascular lesion with a pinkish look. It usually appears like small and thin vessels on the surface, generally on the forehead, nose, and on the occipital region of new-borns. The lesions on the face disappear always. However, lesions located on the occipital region last throughout adulthood.
Treatment for angiomas
Generally, most angiomas disappear without the need for treatment. In any case, when a baby is born with angioma, you should consult a dermatologist in order to assess the need of a treatment.
If the angioma does not require treatment, a significant monitoring must be done in order to detect any possible change. These changes could be: infection, bleeding, or sudden growth. In case of an emergency, apply gauze bandage, press slightly on the angioma, and go to the doctor.
Recent studies on strawberry and cavernous angiomas recommend avoiding treatment for at least four years, as a spontaneous regression usually occurs after that period. In addition, adding any treatment might cause a mark or scar.
Cortisone might help in cases where angiomas grow fast. In any case, laser is obtaining positive results.
Diagnosis and treatment of angiomas in Valencia
• Dr. Gabriel Serrano Sanmiguel