Strawberry naevus
Presentation
- Usually occurs on face in first few weeks after birth, in 3-5% of babies
- Begins flat, then develops raised strawberry-like areas
- Growth may continue for three to four years until regression
- Where large and affecting blood flow to limbs, growth may be affected
- Head and neck lesions may affect vision and breathing
Management
- If diagnosis is in doubt, MRI or ultrasound can be helpful
- Treatment not usually required; full regression usually after 10 years
- Treatment options, when required, include propranolol, intralesional steroids, interferon or imiquimod
Spider naevus
Spider naevus
Presentation
- Localised telangiectasia arising from one central vessel
- Found in distribution of superior vena cava; on hands in young children
- Occurs in 10-15% of healthy children and adults; can be more common in pregnancy
- Where more than three present, may be a sign of liver disease
Management
- Treatment not usually required – may regress spontaneously
- If associated with liver disease, treating liver may lead to regression
- If treatment required, electrocautery or laser can be helpful
- Treatment should be aimed at the central vessel
Cherry haemangioma
Cherry haemangioma
Presentation
- Cherry red papules associated with underlying abnormal proliferation of blood vessels
- Colour ranges from bright red to purple
- Common benign lesions, especially on torso, where they are often multiple, called Campbell de Morgan spots
- Usually small, but may be up to 1cm diameter
Management
- Treatment rarely required and may result in scarring
- Recurrent trauma can lead to troublesome bleeding
- Treatment options include electrocautery, excision and lasers
Telangiectasia
Insect bite
Presentation
- Small dilated blood vessels near surface of skin, 0.5-1mm diameter
- Can also occur on mucous membranes
- Can develop anywhere, but most commonly seen on face
- Multiple causes; in this case, following radiotherapy
Management
- Treatment not usually required
- When occurring on lower leg, 88% associated with underlying venous reflux disease
- Treatment includes lasers or localised sclerotherapy
- Extensive camouflage can be helpful
- Dr Nigel Stollery is a GP in Leicestershire
