Videodermoscopy and Doppler-ultrasound in spider naevi: towards a new classification?

Abstract

Introduction

spider naevi (SN) are considered a subtype of telangiectasias, currently classified as low-flow vascular malformations.

Objective

to describe the videodermoscopy and doppler-ultrasound (US) features of a large group of SN.

Material and Methods

a retrospective study of cases of SN collected at our Dermatology department during the period between June 2015- June 2017 was performed. Clinical, dermoscopic, videodermoscopic and Doppler-US were reviewed. For each case, the age of the patient, time since onset, size and dermoscopic pattern of the lesions were recorded. The presence of pulsatility was also evaluated visually on the videodermoscopy.

Results

233 SN in 189 patients were included. The mean age was 39.5 years (range: 10-76 years). Mean size of the lesions was 4.1 mm +/- 2.0 mm. We described three dermoscopic patterns: network, star and looping. Older age, longer time since onset and larger size were found associated to higher frequency of the looping and star patterns compared to that of newtwork pattern (p<0.01). Pulsatility during videodermoscopy was found in 88 patients (37%). This pulsatility phenomenon was more commonly associated to the looping pattern (64.7%) than star (40.3%) or network-like patterns (29.9%) (p<0.001). In Doppler-US studies a high-flow with arterial biphasic waveform was found.

Conclusions

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.

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