Anatomic Distribution of Cherry Angiomas in the General Population

Abstract

<b><i>Background:</i></b> Cherry angiomas are common benign vascular skin lesions of unknown aetiology, found largely on the trunk. However, their exact anatomic distribution besides their truncal predisposition, and how they manifest in the general population, has not been characterised. <b><i>Methods:</i></b> Three-dimensional (3D) total body imaging was obtained from 163 adult participants of a general population cohort study in Brisbane, Australia. Demographic, phenotypic, and sun behaviour characteristics were collected using a standard questionnaire along with history of melanoma and keratinocyte cancers. Cherry angiomas were identified using an automated classification algorithm with a sensitivity of 87% and a specificity of 99%, developed specifically for this study population. <b><i>Results:</i></b> The 3D total body images of 163 participants were analysed. Participants had a median age of 57 years and 61% were male. On average, males had more angiomas than females (median of 16 vs. 12) and the number and size of cherry angiomas increased with age. In addition to male sex and age, an increase in angiomas was associated with Caucasian ancestry other than British/Irish only, fair skin colour opposed to medium/olive, having green/hazel eyes compared to blue/grey, and personal history of melanoma. The most common site for cherry angiomas was the front trunk, followed by the back. Interestingly, although males had more angiomas overall, females had more angiomas on the legs. <b><i>Conclusion:</i></b> Describing the distribution of cherry angiomas by body site is an important step towards further understanding of the aetiology of angiomas. While personal history of melanoma is associated with an increased number of cherry angiomas, whether this association is prognostic, co-occurs with development of melanoma, or is merely fortuitous requires further investigation.

Approach of Multiple Endocrine Neoplasia Type 1 (MEN1) Syndrome–Related Skin Tumors

“…Belonging to the category of (skin) angiomas, cherry angiomas represents a distinct skin tumor apart from angiofibromas and have been associated with acromegaly, either sporadic or syndromic. Cherry angiomas are benign tumors caused by the proliferation of endothelial cells and are composed of tiny vascular channels originating from post-capillary venules in the upper part of the dermis [ 101 , 102 , 103 ]. Macroscopically, they present as red, small papules, and are most frequently located on the trunk and extremities [ 101 , 104 , 105 ].…”

Treatment of superficial benign vascular tumors by high intensity focused ultrasound: Observations in two illustrative cases

“…As both strawberry marks and cherry angiomas are predominantly benign and asymptomatic, they are often only treated for medical reasons in special situations where they ulcerate, cause pain, or in other ways impair the person's development or daily life 1–6 7,8 treatments with the primary objective of improved aesthetic appearance are, however, much more problematic.…”

“…Almost all humans at the age above 70 years will have at least one, and typically several, most often located on the trunk. 1,2,6 As both strawberry marks and cherry angiomas are predominantly benign and asymptomatic, they are often only treated for medical reasons in special situations where they ulcerate, cause pain, or in other ways impair the person's development or daily life. [1][2][3][4][5][6] While such treatments generally have low rates of adverse events from a strictly curative viewpoint, 7,8 treatments with the primary objective of improved aesthetic appearance are, however, much more problematic.…”

“…These tumors presents as round, slightly elevated, ruby red papules of up to 10 mm in diameter. Almost all humans at the age above 70 years will have at least one, and typically several, most often located on the trunk 1,2,6 …”

“…Likewise, surgical methods, such as excision, electrocautery, or cryotherapy, also frequently give a final appearance of the involved area that is less favorable than the baseline. In many cases, patients are therefore cautioned against intervention in consideration of the benign nature of the condition 1–6 . Persisting lesions, in particular originating from non‐involuting congenital/infantile hemangiomas in young people, may, however, cause significant psychosocial problems and low self‐esteem 9 …”