Videodermoscopy and doppler‐ultrasound in spider naevi: towards a new classification?

Alegre-Sánchez, A.; Bernárdez, C.; Fonda‐Pascual, Pablo; Moreno‐Arrones, Óscar M.; López‐Gutiérrez, Juan Carlos; Jaén‐Olasolo, Pedro; Boixeda, P.

doi:10.1111/jdv.14602

Cited by 9 publications

(8 citation statements)

References 21 publications

(20 reference statements)

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“…Telangiectasia is a very heterogeneous group characterized by dilated capillary vessels. Although, according to ISSVA, telangiectasias are classified as CMs, most of them (such as in Rendu Osler Weber syndrome) present as high flow lesions 4 …”

Section: Introductionmentioning

confidence: 99%

Characteristics of mucocutaneous vascular malformations drawn from a decade of a multidisciplinary committee experience

Estébanez

Puche‐Torres

García

et al. 2021

Dermatologic Therapy

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Vascular malformations (VM) are congenital, benign, and relatively frequent lesions. Scant data have been published about the epidemiology, clinical presentation, and treatment of VM from a dermatologist's perspective. The substantial differences between subtypes, broad range of specialists consulted and confusing nomenclature used over previous years may hamper a correct diagnosis. The main objective of this study is to describe VM epidemiology. As a secondary endpoint we evaluate clinical characteristics, clinical‐radiological correlation and treatment approaches. We carried out an observational, descriptive, retrospective study. Cases presented to the multidisciplinary committee of our hospital from 2009 to 2019 were retrieved. Electronic medical records, monthly committee reports and the iconographic archive were reviewed and statistically analyzed. Overall, venous malformations (VeM) are the most frequent VM, followed by capillary malformations (CM), arterioVeM and lymphatic malformations (LM). Considering only patients under 16, CMs are the most frequent ones. Capillary and LMs are larger than venous or arteriovenous. While CMs are usually asymptomatic, symptomatic cases are threefold more frequent in the other subtypes. Decisions on active or conservative management depend on VM size but not location or patient age. CMs are mainly treated with laser therapy; venous with sclerotherapy or surgery; arteriovenous with surgery and lymphatic with surgery or sirolimus. Dermatologists play an important role in VM diagnosis and management. Our 10‐year multidisciplinary experience should contribute to the literature and represent a practical resource for clinicians and researchers.

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Section: Introductionmentioning

confidence: 99%

Characteristics of mucocutaneous vascular malformations drawn from a decade of a multidisciplinary committee experience

Estébanez

Puche‐Torres

García

et al. 2021

Dermatologic Therapy

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“…Spider nevi were historically classified as low-flow capillary malformations [92]; however, a 2017 study by Alegre-Sanchez et al found that spider nevi demonstrated pulsatile flow on dermoscopy and ultrasound. This finding was subsequently supported by the presence of high-flow arterial-type waveform as seen on Doppler-ultrasound, suggesting that spider nevi are more similar to arteriovenous malformations, or highflow vascular lesions [91].…”

Section: Vascular Lesionsmentioning

confidence: 78%

“…Another type of vascular lesion known as a Spider nevus has also been characterized using ultrasound [91]. Spider nevi were historically classified as low-flow capillary malformations [92]; however, a 2017 study by Alegre-Sanchez et al found that spider nevi demonstrated pulsatile flow on dermoscopy and ultrasound.…”

Section: Vascular Lesionsmentioning

confidence: 99%

High-frequency ultrasound in clinical dermatology: a review

et al. 2021

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Background Ultrasound was first introduced in clinical dermatology in 1979. Since that time, ultrasound technology has continued to develop along with its popularity and utility. Main text summary Today, high-frequency ultrasound (HFUS), or ultrasound using a frequency of at least 10 megahertz (MHz), allows for high-resolution imaging of the skin from the stratum corneum to the deep fascia. This non-invasive and easy-to-interpret tool allows physicians to assess skin findings in real-time, enabling enhanced diagnostic, management, and surgical capabilities. In this review, we discuss how HFUS fits into the landscape of skin imaging. We provide a brief history of its introduction to dermatology, explain key principles of ultrasonography, and review its use in characterizing normal skin, common neoplasms of the skin, dermatologic diseases and cosmetic dermatology. Conclusion As frequency advancements in ultrasonography continue, the broad applications of this imaging modality will continue to grow. HFUS is a fast, safe and readily available tool that can aid in diagnosing, monitoring and treating dermatologic conditions by providing more objective assessment measures.

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“…A previous study recommended that SN could be reclassified as belonging to the group of high-flow arteriovenous malformations. [1]…”

Section: Discussionmentioning

confidence: 99%

“…SN appears as single or multiple lesions that are present in up to 15% of healthy adults, with a higher incidence among children. [1] SN have been treated for cosmetic purposes via electrocoagulation, pulsed-dye lasers (PDL), potassium-titanyl phosphate (KTP) lasers, and neodymium:yttrium-aluminium-garnet (Nd:YAG) lasers. [2–5] However, the complete removal of these skin lesions often requires multiple treatments, especially for SN with a body diameter ≥1 mm; this may be due to the thick arterial walls or because the large blood flow in the small arteries of SN can easily dissipate the heat from the laser.…”

Section: Introductionmentioning

confidence: 99%

Clinical efficacy of 595-nm pulsed-dye laser in treatment of childhood facial spider nevi

Zhang

Yang

et al. 2019

Chinese Medical Journal

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Background:Spider nevi (SN) are quite common in children. SN are treated via different techniques, and complete removal often requires multiple treatments. However, few studies have evaluated the treatment of SN. The present study aimed to evaluate the therapeutic effect and safety of a 595-nm pulsed-dye laser (PDL) for treating facial SN in children.Methods:A total of 110 children aged 0.2 to 12 years with facial SN were treated with a 595-nm PDL in a single institution from January 2016 to February 2018. In accordance with the treatment method, the patients were retrospectively divided into the small-spot-combined-with-large-spot group (SL-group) and the large-spot group (L-group). Patients with poor therapeutic results were re-treated every 6 weeks until the lesions disappeared. The minimum follow-up period was 1 year. The groups were compared using independent-samples t tests, Mann-Whitney U test, Chi-square test, and Fisher exact probability test.Results:The therapeutic efficacy was significantly higher in the SL-group than in the L-group, with clearance rates of 90.9% and 53.0% after the primary treatment, respectively (χ2 = 17.937, P < 0.001). For skin lesions with a central spider body diameter ≥1 mm, the once-treatment cure rates were 100% in the SL-group and 34.8% in the L-group (χ2 = 20.780, P < 0.001). For skin lesions with a central spider body diameter <1 mm, the once-treatment cure rates were 82.6% in the SL-group and 62.8% in the L-group (χ2 = 3.961, P = 0.138). The rates of adverse reactions and recurrence did not differ between the two groups (P = 0.141 and P = 1.000, respectively).Conclusions:The 595-nm PDL might be a safe and effective treatment option for facial SN in children. The small-spot-combined-with-large-spot method is especially suitable for SN with a central spider body diameter ≥1 mm.

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Videodermoscopy and doppler‐ultrasound in spider naevi: towards a new classification?

Abstract: In the light of the results, we support that SN could be reconsidered in upcoming classifications as lesions closer to the group of high-flow arteriovenous malformations.

Cited by 9 publications

References 21 publications

Characteristics of mucocutaneous vascular malformations drawn from a decade of a multidisciplinary committee experience

Characteristics of mucocutaneous vascular malformations drawn from a decade of a multidisciplinary committee experience

High-frequency ultrasound in clinical dermatology: a review

Clinical efficacy of 595-nm pulsed-dye laser in treatment of childhood facial spider nevi

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