Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
Dermatology, Complejo Hospitalario Ruber Juan Bravo, Madrid, Spain.
J Eur Acad Dermatol Venereol. 2018 Jan;32(1):156-159. doi: 10.1111/jdv.14602. Epub 2017 Oct 17.
Spider naevi (SN) are considered a subtype of telangiectasias, currently classified as low-flow vascular malformations.
To describe the videodermoscopy and Doppler-ultrasound (US) features of a large group of SN.
A retrospective study of cases of SN collected at our Dermatology department during the period between June 2015 and June 2017 was performed. Clinical images, dermoscopic, videodermoscopic and Doppler-US files 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.
Two hundred and thirty-three 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 ± 2.0 mm. We described three dermoscopic patterns: network, star and looping. Older age, longer time since onset and larger size were found associated with higher frequency of the looping and star patterns compared to that of network pattern (P < 0.01). Pulsatility during videodermoscopy was found in 88 patients (37%). This pulsatility phenomenon was more commonly associated with 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.
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.
蜘蛛痣（SN）被认为是毛细血管扩张症的一种亚型，目前被归类为低流量血管畸形。
描述一大组蜘蛛痣的视频皮肤镜和多普勒超声（US）特征。
对 2015 年 6 月至 2017 年 6 月期间在皮肤科收集的 SN 病例进行回顾性研究。回顾了临床图像、皮肤镜、视频皮肤镜和多普勒-US 图像。记录了每个病例的患者年龄、发病时间、病变大小和皮肤镜模式。还在视频皮肤镜上对搏动的存在进行了直观评估。
共纳入 189 例患者的 233 个 SN。患者平均年龄为 39.5 岁（范围：10-76 岁）。病变平均大小为 4.1±2.0mm。我们描述了三种皮肤镜模式：网状、星状和环状。与网状模式相比，年龄较大、发病时间较长、病变较大与环状和星状模式的出现频率更高相关（P<0.01）。88 例（37%）患者在视频皮肤镜下可见搏动。这种搏动现象更常见于环状模式（64.7%），而不是星状（40.3%）或网状模式（29.9%）（P<0.001）。在多普勒-US 研究中，发现了一种高流量伴动脉双相波的现象。
根据这些结果，我们支持将 SN 在即将到来的分类中重新考虑为更接近高流量动静脉畸形组的病变。
