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