🔴🟡🟢 Hepatology Bedside Pearls!
I was pleasantly surprised by the overwhelming response to a tweetorial posted yday.
So here's one for those who want more. Do let me know if you like similar tweetorials in Clin Med/Hepat/GE.
This time, Spider Naevi!
I was pleasantly surprised by the overwhelming response to a tweetorial posted yday.
So here's one for those who want more. Do let me know if you like similar tweetorials in Clin Med/Hepat/GE.
This time, Spider Naevi!
🟡 What's a spider nevus?
Aka Nevus araneus/ spider angiomata
It has 5 components: cutaneous arterial net, central arteriole, subepidermal ampulla, ⭐ shaped afferents & capillaries (J Am Acd Dermatol 1997)
0.1- 1cm, sometimes huge
Warmer than surrounding
Aka Nevus araneus/ spider angiomata
It has 5 components: cutaneous arterial net, central arteriole, subepidermal ampulla, ⭐ shaped afferents & capillaries (J Am Acd Dermatol 1997)
0.1- 1cm, sometimes huge
Warmer than surrounding
🟡 Associations?
✔10-15% healthy children
✔Pregnancy, OCP
✔Thyrotoxicosis
✔Liver ds esp Alcohol >>HCV rel
✔HPS
✔Malnourishment
✔10-15% healthy children
✔Pregnancy, OCP
✔Thyrotoxicosis
✔Liver ds esp Alcohol >>HCV rel
✔HPS
✔Malnourishment
🟡Sites to look for?
✔SVC Territory ( ?? Sun exposed areas)
✔Upper airway mucosa
✔✋of healthy children
✔Autopsy: pleural & subpleural
(J Postgrad Med 2002)
Unusual below nipples and on palms & hands in adults
✔SVC Territory ( ?? Sun exposed areas)
✔Upper airway mucosa
✔✋of healthy children
✔Autopsy: pleural & subpleural
(J Postgrad Med 2002)
Unusual below nipples and on palms & hands in adults
🟡 Pathophysiology?
? Estrogen excess, incr in Estrogen: Testosterone ratio
? Direct effect of EtOH
? VEGF, bEGF, Subs P
? Estrogen excess, incr in Estrogen: Testosterone ratio
? Direct effect of EtOH
? VEGF, bEGF, Subs P
🟡When do spiders disappear?
✔ Children, with age
✔Postpartum, stoppage of OCPs
✔improving liver fn
✔Worsening liver fn
✔Shock
✔ Children, with age
✔Postpartum, stoppage of OCPs
✔improving liver fn
✔Worsening liver fn
✔Shock
🟡Demonstration
Diascopy, glass slide or pin head 📍
Blanching⏩Filling centre to periphery
Diascopy, glass slide or pin head 📍
Blanching⏩Filling centre to periphery
🟢Bonus for quiz enthusiast😆😆
The name seemed to originate in the dingy bars of New York, where the barmaids identified the "problem drinkers" by this sign.
Incredible ain't it?
(Fitzpatrick's Dermatology in Gen Med, 1999)
The name seemed to originate in the dingy bars of New York, where the barmaids identified the "problem drinkers" by this sign.
Incredible ain't it?
(Fitzpatrick's Dermatology in Gen Med, 1999)
🟡Personal experiences.
I had two cases @HepatologyPGI of large eye lid angiomas that bled profusely requiring multi-modality Rx.
And below a pt with angioma at a rather uncommon site.
I had two cases @HepatologyPGI of large eye lid angiomas that bled profusely requiring multi-modality Rx.
And below a pt with angioma at a rather uncommon site.
🟢For the history buffs
🥇Sir Erasmus Wilson in 1867
🇬🇧 Surgeon & eminent Dermatologist
Known as the father of British Dermatology!
(RM Hadley, Med Hist 1959; Bean WB, 1958)
🥇Sir Erasmus Wilson in 1867
🇬🇧 Surgeon & eminent Dermatologist
Known as the father of British Dermatology!
(RM Hadley, Med Hist 1959; Bean WB, 1958)
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