Differential diagnosis includes Telangiectases, blood vessel tumours such as infantile haemangiomas and angiomas that arise in adults; and capillary or venous vascular malformations.

But here it is Telangiectasia

Telangiectasia

Telangiectasias are small, broken, or widened blood vessels found near the surface of the skin or mucous membranes. These are also called telangiectases. Visible small blood vessels that are blue in colour (spider veins) are called venulectasia, because venules are involved.

They typically appear as fine pink or red lines and will whiten when under pressure. Once the telangiectasia appears on the skin, the tiny lines can range in color from red through blue and purple.

Telangiectasias typically measure between 1 and 3 millimeters in width. They are usually harmless but can cause itching and be painful because of pressure on the small veins.

Telangiectasia is a component of the CREST variant of scleroderma, also known today as limited scleroderma (CREST is an acronym that stands for calcinosis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia).

Cause of Telangiectasia

Physical associated telangiectases as a result of:

  • Actinic or sun damage
  • Pregnancy
  • Radiation therapy
  • Post-surgery along flap or excision lines
  •  Erythema ab igne.
  •  Livedoid vasculopathy and atrophie blanche

Blood vessels secondary to primary condition in:

  • Rosacea
  • Poikiloderma of civatte
  • Hormonal or pregnancy associated spider telangiectasia

Conditions associated with telangiectases include:

  • Connective tissue diseases, including Crest syndrome and Lupus
  • Hereditary hemorrhagic telangiectasia
  • Generalised essential telangiectasia
  • Bloom syndrome
  • Cockayne syndrome
  • Cutis marmorata telangiectatica congenita
  • Focal dermal hypoplasia (Goltz syndrome)
  • Kindler syndrome

Note that telangiectasia may be noted as a normal feature of facial skin in some families.

Signs and Symptoms

Telangiectasias can be seen anywhere on the body. They are common on the face (nose, cheeks, and chin) and legs (particularly the thighs, just below the knees and the ankles).

Telangiectasias are red, blue, or purple linear marks measuring less than 1–3 mm in width and several millimeters to centimeters in length, and they can disappear temporarily if you press on them with your finger.

 Treatment

Telangiectases are generally harmless. Treatment may be sought because of bleeding or unsightly appearance. Facial red vein treatment methods include:

  • Electrosurgery
  • Intense pulsed light (IPL)
  • Vascular laser treatment
  • Sclerotherapy.

 

  • Hyfrectation and electrocautery

Fine needle hyfrector may be used but there are more side effects than with laser therapy.

  • Intense pulse light treatment (IPL)

IPL can be very effective in treating small to medium-sized facial telangiectases. Larger telangiectases respond better to longer wavelength lasers.

  • Lasers

Laser therapy is an effective method for treating facial telangiectases. The correct types of lasers are readily available in many dermatologist practices. Lunchtime procedures can be organised depending on the extent of the area being treated.

    • 532 nm KTP laser can be used as a tracing laser for small to medium-sized telangiectases
    • 595 nm pulse dye laser is effective for diffuse erythema and small to medium-sized telangiectases
    • 755 nm Alexandrite lasers can be used for treatment-resistant telangiectases or in darker skin types
    • 1064 nm long pulse Nd YAG lasers can be used to treat deeper and larger telangiectasias
    • Other less commonly used lasers include the copper bromide laser and diode lasers.
  • Sclerotherapy is more effective in treating telangiectases on the legs.
  • Camouflage cream

Colour matched makeup is an excellent method of covering up redness associated with telangiectases. Green-tinted foundations and creams are especially helpful in concealing redness.

Future outcome

They are harmless and the vast majority of cases are not associated with an underlying medical condition. Laser treatment, when performed by a dermatologist, often removes these spots safely and effectively.