Vascular ectasias
- Lesion
Ectasias are dilated pre-existing small vessels, not tumours: red-purple patches, spider-shaped spots or tiny red dots that bleed.
What it is
Vascular ectasias are local dilations of existing vessels. The nevus flammeus is a congenital flat pink-purple patch; the port-wine stain is a type that persists, grows with the child and may be part of Sturge–Weber syndrome. Spider telangiectasias are radiating arterioles around a central core that blanch with pressure; they appear with high estrogen (pregnancy, cirrhosis). Hereditary haemorrhagic telangiectasia is an autosomal dominant disorder of TGF-β family signalling with telangiectasias of skin and mucosa and arteriovenous malformations in lung, liver and brain.
Structure
- Nevus flammeus: dilated capillaries in the dermis.
- Spider telangiectasia: a central pulsating arteriole with radiating thin-walled vessels.
- HHT: dilated thin-walled capillaries and venules connected directly to arterioles in mucosa and skin.
Three ectasias to recognise
| Lesion | Appearance | Associations |
|---|---|---|
| Nevus flammeus and port-wine stain | Flat pink to purple patch present at birth | Sturge–Weber syndrome when on the face with brain involvement |
| Spider telangiectasia | Red central point with radiating legs that blanch | Pregnancy, cirrhosis, high estrogen |
| Hereditary haemorrhagic telangiectasia | Small red spots on lips, tongue, nose, fingertips | Nosebleeds, GI bleeding, AV malformations of lung, liver, brain |
Clinical notes
- Chronic blood loss in HHT is a frequent cause of iron-deficiency anaemia; screening for lung and brain AV malformations is advised.
Test yourself
Think of the answer, then tap the question to see it.
What is the inheritance pattern of hereditary haemorrhagic telangiectasia?
Autosomal dominant (genes such as ENG, ACVRL1 and SMAD4 in the TGF-β/BMP pathway).
Why do spider angiomas appear in cirrhosis?
The failing liver clears estrogen poorly; hyperestrogenism dilates small arterioles of the skin.
Which syndrome combines a facial port-wine stain, leptomeningeal angiomas and seizures?
Sturge–Weber syndrome.
Elsewhere in DurgiPedia
Connections
Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.
Sources: Hereditary hemorrhagic telangiectasia: MedlinePlus Genetics (MedlinePlus, US National Library of Medicine, 2025).
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Representative model, for educational purposes only.