Angioma: definition
"Angioma" is a misnomer used to refer to most dermatological vascular dysfunctions, which include both malformations and vascular tumors.
For angioma, commonly, it means a benign tumor that manifests itself in small blood vessels. These tumors can be located anywhere in the body, but they are almost never considered dangerous; sometimes, however, angioma hides much more serious disorders, such as liver cirrhosis.
General classification
Angiomas can be classified into four general categories:- stellar angioma, also called angioma spider
- angioma "cherry", also called ruby angioma or senile angioma
- infantile haemangiomas
- Hutchinson's serpigous angioma
The stellar angioma is the most widespread: it is so called because a vessel undergoes a dilatation, which in the skin appears as a small red dot surrounded by an erythematous halo, which forms a sort of capillary network arranged in a radius ("stellar") or a species of spider web (angioma spider). It is a malformation that affects infants and young people. The cause of origin is doubtful: however, based on a hypothesis, it appears that the stellar angioma is the result of microtraumas repeated over time, since they are always found at the skin level. Usually they are not treated with laser, as they do not give good results: the stellar angioma remains an aesthetic problem.
The cherry angioma can appear anywhere in the body, but tends to develop at the level of the trunk; generally, the ruby angioma affects subjects after age 40 (not surprisingly, it is also called senile angioma). The cherry angioma is relatively small and has a smooth and bright red colored surface (hence, the name "cherry"). The expert dermatologist generally diagnoses the disorder by analyzing the appearance and growth of the angioma; however, biopsy is useful to confirm the diagnosis. The senile angiomas can also be very numerous, but do not lead to any disturbance of pathological interest: therefore they remain only an aesthetic misunderstanding.
Infantile haemangiomas are also called capillary hemangiomas, more commonly known as birthmarks : they manifest themselves with embossed spots on the skin, red-burgundy in color. They are congenital, that is to say present on the skin of the newborn already at birth, but can also occur some weeks or months later. Infantile haemangiomas, after rapid expansion, generally regress to disappear completely; if this does not happen, and if the desire creates a serious aesthetic disorder for the subject, laser treatment could be used.
Hutchinson's serpiginous angioma occurs in children or young people: in the first stage, the angioma has a slight small relief. Subsequently, it tends to expand, presenting a mentioned atrophy in the center, consequently, annular, reticular and serpiginous formations occur.
Structural classification
A further classification groups angiomas according to their clinical appearance:
- angioma plane
- tuberous angioma
- cavernous angioma
In some respects, infantile haemangiomas can be included in the category of plane angiomas : the surface of the angioma is smooth, the extension variable and the color of the dark spot.
It is usually localized at the level of the face and neck. The angioma plane, unlike infantile hemangiomas, is permanent and does not disappear with growth; on the contrary, it could progress altering its structure: the angioma can thicken and the surface may appear wrinkled, irregular, nodular.
The tuberous angiomas are so called to indicate their surface, decidedly more irregular and nodular than the plane angioma ; the tuberous angioma, at sight, appears purplish-red or tending to blue. It is congenital and usually disappears spontaneously. It could affect not only the skin but also the mucous membranes.
The name " cavernous " already gives an idea about the morphology of the angioma: it is localized in depth of the subcutaneous tissue, like a dilatation and circumscribed swelling, with a bluish and elastic color. As the cavernous angioma progresses, it tends to deform the point at which it is undermined: it does not naturally regress and the surface may become covered with micro-telangiectasias.
Additional classifications
Based on the degree of differentiation achieved, the angiomas are divided into five other classes:
- venous angiomas
- arteriovenous angiomas
- immature capillary angiomas
- mature capillary angiomas
- mixed / complex angiodysplasias
Venous angiomas do not spontaneously regress: they represent small dilations of venous districts, whose veins are radially arranged; they differ from arteriovenous angiomas, which are also placed at the level of soft tissues, the head or limbs. They are vascular anomalies of surgical interest.
Generally, immature capillary angiomas develop after a few months of life, but can regress with age; the vascular cells that have evolved into capillaries are affected (hence "immature capillaries").
Mature capillary angiomas, on the other hand, involve true capillaries, destined to dysplasia (abnormal capillary cellular composition). They are permanent and only surgery can eliminate them.
The mixed / complex angiodysplasias involve the lymphatic, arterial or venous system, whose alterations can be associated with hypotrophy or hypertrophy of the limbs.
As analyzed, the angiomas are numerous and diversified; the specialist must encourage the patient suffering from angioma to follow a suitable, adequate and personalized therapy to eliminate the problem permanently.
Angiomas: causes and treatments »
