Report

A clinical approach to diagnose patients with localized

telangiectasia
Ruchi Gupta1, MD, Ram Krishan Gautam1, MD, DVD, MNAMS, Minakshi Bhardwaj2, MD,
and Amrita Chauhan1, MD

1
Department of Dermatology STD &
Leprosy, and 2Department of Pathology,
P.G.I.M.E.R. and Dr Ram Manohar Lohia
Hospital, New Delhi, India
Correspondence
Ruchi Gupta, MD
Senior Resident
Department of Dermatology STD & Leprosy
P.G.I.M.E.R. and Dr Ram Manohar Lohia
Hospital
Baba Kharag Singh Marg,
New Delhi 110001
India
E-mail: ruchi85mon@gmail.com
Conflicts of interest: None.
Funding support: None.
Abstract
Telangiectasia, or dilated blood vessels, may represent a benign condition or a marker of a
much more serious internal or cutaneous malignancy (e.g. mycosis fungoides). They can
be generalized or localized in distribution. ‘Localized telangiectasia’ can be macular or
papular. Macular ones can be further divided into two major categories: primary and
secondary. They can occur on their own (primary), after skin injury (e.g. sun damage, post-
radiation therapy, after prolonged topical steroid application), or may arise due to an
underlying condition (secondary). While telangiectases can spring from a multitude of
possible causes, the location of the lesions, in combination with a careful history and
exmination, often helps in elucidating the correct diagnosis. A patient with localized
telangiectasia as a manifestation of malignancy may be difficult to diagnose, however the
diagnosis is one of exclusion, and a thorough evaluation should be performed before
diagnosing this condition. This article reviews possible conditions to consider in these
patients and suggests an approach to their evaluation.

adenopathy. The laboratory findings, including basophils

Introduction
One of the difficulties dermatologists encounter when
attempting to diagnose conditions with localized telangi-
ectasia is where to start. Faced with such a patient, it is
helpful to have a systematic approach rather than simply
thumb through the books. We hereby present a case with
unilateral dermatomal telangiectasia with an approach to
categorize and diagnose such cases.
Illustrative case
A 31-year-old woman presented with spontaneous erup-
tion of asymptomatic, red–tan spots on the inner side of
her left arm during her immediate postpartum period.
There were no systemic features. She did not have any
family members with similar skin lesions. On examina-
tion, multiple brownish erythematous macules (2–6 mm
in diameter) with telangiectasias were seen arranged line-
arly over the medial aspect of the left arm, involving an
approximately 10 cm long area in the distribution of the
intercostobrachial nerve (T2 dermatome) extending to
involve the lateral wall of the axilla (Fig. 1). The lesion
blanched on diascopy but did not urticate or itch after a
brisk stroke. There was no hepatosplenomegaly or lymph-
e294
in the peripheral blood smear, liver transaminases, alka-
line phosphatase, serum estradiol, and thyroid hormones,
were within normal limits. Suspecting the possibility of
unilateral nevoid telangiectasia (UNT), telangiectasia
macularis eruptiva perstans (TMEP), or morphea, we per-
formed a skin biopsy, which showed dilated thin-walled
capillaries with mild perivascular inflammatory infiltrate
comprised of lymphocytes and spindle-shaped toluidine
blue-positive mast cells (Fig. 2). There was no remarkable
sclerosis in the dermis. Thus, a diagnosis of TMEP was
made.
Discussion
Telangiectasias are defined as visibly dilated blood vessels
in the skin. Most commonly, they appear on the skin and
mucous membranes as small red linear markings. Ultra-
structurally, telangiectasias are not vascular proliferations
but are caused by dilations of pre-existing vessels, which
include either capillaries or venules.1 Capillary telangiec-
tasias appear red or pink and are usually less than
0.2 mm in diameter, unlike venous telangiectasias, which
usually appear more blue in color and are greater than
0.2 mm in diameter. Capillaries are usually bilateral and

International Journal of Dermatology 2015, 54, e294–e301 ª 2015 The International Society of Dermatology
Gupta et al.
Figure 1 Multiple red tan macules (2–6 mm in diameter)
arranged linearly over medial aspect of left arm, in the
distribution of intercostobrachial nerve (T2 dermatome)
are symmetrically distributed on the skin. When they are
numerous enough to become confluent, the skin appears
diffusely erythematous, and discerning individual telangi-
ectasias becomes impossible.
Morphologically they can also be broadly divided into
two groups: (a) macular, which may be further subdi-
vided into linear (e.g., most commonly visible over ala of
nosa), arborized or Besenreiser type (e.g., on thigh), spi-
der or star-like, and punctiform type; and (b) papular
(e.g., cherry angioma, angiokeratoma, etc.). Braverman
and Ken-Yen performed ultrastructural analyses of telan-
giectasias in various disorders by light and electron
microscopy and found that macular telangiectasias are
produced by dilatation of postcapillary venules of the
upper horizontal plexus, whereas papular telangiectasias
are produced by spherical and tubular dilatations of capil-
lary loops in dermal papillae.2
In this review, we will focus only on superficial macu-
lar telangiectasia in a localized distribution. As a signifi-
cant group of disorders present with superficial macular
telangiectasias in a localized and/or dermatomal distribu-
tion, there is a need for an approach to categorize and
diagnose such cases (Fig. 3). From a pathophysiological
point of view, macular telangiectasias are divided into
two major categories: primary and secondary. They can
occur on their own (primary), after skin injury (e.g., sun
damage, post-radiation therapy, after prolonged topical
steroid application), or may arise due to an underlying
condition (secondary). While telangiectasias can spring
from a multitude of possible causes, the location of the
lesions, in combination with a careful history and exami-
ª 2015 The International Society of Dermatology
Diagnosing patients with localized telangiectasia Report e295
(a)
(b)
Figure 2 (a) Multiple dilated thin-walled capillaries with
mild perivascular inflammatory infiltrate in papillary dermis
(hematoxylin and eosin stain, 940 magnification). (b)
Spindle-shaped toluidine blue positive mast cells in
perivascular location (toluidine blue stain; 9100
magnification)
nation, often helps in elucidating the correct diagnosis.
Notably, the presence or absence of atrophy in lesional
skin helps to narrow down the clinical diagnosis further.
Eventually, in doubtful cases, skin biopsy is the tool to
reach the final verdict.
Primary localized telangiectasia without skin atrophy
The differential diagnosis engendered by primary local-
ized telangiectasia without skin atrophy is broad and
encompasses disorders, such as UNT, spider nevi, costal
fringe, telangiectasia associated with HIV, angel’s kiss,
stork bite, angioma serpiginosum, and rarely nevus
flammeus. In unilateral nevoid telangiectasias, which were
the initial primary diagnostic consideration in our patient,
there are patches of superficial telangiectasias in a unilat-
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e296 Report Diagnosing patients with localized telangiectasia Gupta et al.

Localized macular telangiectasia

Primary (not associated with Secondary (when

any other distinct primary telangiectasias are one of
disease) the features of a
distinct primary
disease)

Associated with Without skin

skin atrophy atrophy Unilateral
nevoid
Without atrophy With atrophy
telangiectasia
Brocq’s telangiectasias In relation to high Yes
Spider nevi Connective tissue disease:
estrogenic states Rosacea
Purpura annularis No - Scleroderma
telangiectodes of - Telangiectoid variant of
Majocchi Mastocytosis DLE
(TMEP)
Elderly age group Childhood and adolescence Poikiloderma of Civatte
Seborrheic (due to actinic damage),
Costal fringe Involve upper half dermatitis
-CM (Stroke bite, Poikiloderma atrophicans
Angel’s kiss, Nevus vasculare (CTCL)
HIV-associated flemmeus) Hereditary
telangiectasias hemorrhagic
Angiolupoid
telangiectasia
sarcoidosis
Involve lower half
Post treatment:
-Angioma
- Steroid application
serpiginosum - Radiation therapy

Figure 3 An approach to a patient with localized macular telangiectasia. CM, capillary malformation; CTCL, cutaneous T-cell
lymphoma; DLE, discoid lupus erythematosus; TMEP, telangiectasia macularis eruptiva perstans

eral dermatomal or linear distribution that can be con-
genital or acquired. The underlying mechanism is believed
to be somatic mosaicism, which is unmasked by a sys-
temic increase in estrogen levels exhibited during preg-
nancy, puberty, and alcoholic cirrhosis.3 The literature
includes reports of UNT associated with hyperthyroid-
ism,4 while other cases showed no associated abnormali-
ties.5 Dermatomes C3–D1 are the most commonly
involved sites.3–5 Histologically, there are multiple
dilated, thin-walled vessels in the papillary and upper
reticular dermis with notable absence of mast cells. Our
patient fulfilled all clinical criteria of UNT, i.e., multiple
blanching telangiectasias primarily in a T2 dermatomal
distribution in a young female during the postpartum per-
iod. If fewer spindle-shaped mast cells were seen on tolui-
dine blue staining, we could have diagnosed our case as
UNT.
Spider nevus is another common telangiectatic condi-
tion frequently associated with a high estrogenic state. It
is usually seen in pregnancy and is frequently associated
with liver disease but may be encountered in up to 15%
of normal people. An arcade of vessels radiating out from
a central arteriole is the most characteristic clinical fea-
ture. The upper half of the body, especially the face,
neck, upper chest, and hands, is the usual site of predilec-
tion. Occurrence in a dermatomal pattern has been
reported.6
The costal fringe consists of a band-like pattern of
venous telangiectasias along the anterolateral costal mar-
gins (Fig. 4). It is an easily recognized entity, usually seen
in elderly men. Association with an underlying disease is
not well established. Sartori et al.7 examined 1523 young,
seronegative, active duty air force personnel (1203 men
and 320 women) between the ages of 17 and 34 years.
The costal fringe was present in only three men (0.2%).
They concluded that the costal fringe is a rare finding in
healthy young adults. On the other hand, linear telangiec-
tasias in a broad, crescent-like distribution across the
chest are a relatively common finding in homosexual men
and are significantly, although not exclusively, associated
with HIV infection.8 Leg veins encountered in the early
stage of chronic venous disease is an important differen-
tial of venous telangiectasias, i.e., C1 stage of venous dis-
ease of legs as per CEAP (Clinical severity, Etiology,
Anatomy, and Pathophysiology) classification. Superficial
spider veins (reticular veins) are seen over the lower leg
in this condition. At this stage, the telangiectasias can be
managed with non-surgical modalities such as the intense
pulsed light system (IPLS). A few studies have reported
the successful use of IPLS for the treatment of leg telangi-

International Journal of Dermatology 2015, 54, e294–e301 ª 2015 The International Society of Dermatology
Gupta et al.
Figure 4 Band-like arrangement of venous telangiectasias
over chest
ectasias ranging in size from 0.1 to 3 mm in diameter.
Green9 reported complete clearance of leg telangiectasias
in 10% of patients, partial clearance in 25% patients,
and no improvement in another 56% of patients with
IPLS. On the other hand, Goldman and Eckhouse10
reported 75–100% clearance of telangiectasias in 79% of
treated patients and better than 50% clearance in 94% of
cases. A very low rate of adverse effects was reported.
Capillary malformations (CMs), visible as telangiectatic
macules, occur in up to 40–50% of newborns. They fade
progressively during infancy and are therefore termed as
fading macular stains. Some CMs, particularly those on
the nape of neck (stork bite) and rarely on the glabellar
region (angel’s kiss), persist into adulthood and are
termed medial telangiectatic nevus. They can be easily
recognized by their typical location and history of pres-
ence since birth. Nevus flammeus may occur on any part
of the body but commonly affects the face in the distribu-
tion of the trigeminal nerve. Initially, the lesions are tel-
angiectatic macules, but with time they may mature into
violaceous plaques; however, they may remain static as
macular stain in 60% of cases.11
The aforementioned conditions are seen most com-
monly above the waist area. Angioma serpiginosum is a
rare unilateral disorder of the superficial blood vessels
affecting areas below the waist (lower limb or buttock),
with female predominance. It usually arises in childhood
and then progresses for a year or more. It is typically seen
as multiple pinpoint, red macules, which have a tendency
to become papular. They occur in groups, which enlarge
via the eruption of new lesions at the periphery, while
those at the center involute. In this manner, small rings
or serpiginous patterns are formed. The palms, soles, and
mucous membranes are spared. Rare bilateral cases with
extensive cutaneous involvement are seen, but most cases
are unilateral.12 Histologically, the presence of dilated
and tortuous capillaries in the dermal papillae and upper
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Diagnosing patients with localized telangiectasia Report e297
dermis is consistent with the propensity of lesions to
become papular. The colloquial differentials are progres-
sive pigmentary purpuric diseases. In Schamberg disease,
the so-called cayenne pepper spots are macules that tend
to coalesce and form diffusely pigmented patches,
whereas purpura annularis telangiectodes of Majocchi,
although bilateral, resemble more closely due to the
occurrence of telangiectatic macules that enlarge peripher-
ally to form small rings (discussed below).
Primary telangiectasia with skin atrophy
Only a few disorders with primary telangiectasia present
with skin atrophy. They include purpura annularis telan-
giectodes of Majocchi and Brocq’s telangiectasias. Pur-
pura annularis telangiectodes of Majocchi, most
commonly seen in adolescents, is characterized by sym-
metrical, purpuric, telangiectatic annular patches and pla-
ques with skin atrophy, with a predilection for the lower
extremities and buttocks. The presence of skin atrophy
and purpura (do not blanch with pressure) clinically and
perivascular inflammatory infiltrate with extravasation of
erythrocytes histologically, differentiate it from angioma
serpinginosum. Although primarily annular, these patches
may be linear, stellate, or serpiginous in shape.13
Brocq’s telangiectasias are essential localized telangiec-
tasias on a sclerodermiform background. Their nosologi-
cal place is not clear among the essential telangiectasias;
morphologically they seem to be quite similar to poikilo-
derma atrophicans vasculare but without any discernable
underlying cause.14
Secondary telangiectasia with skin atrophy
When associated with atrophy, telangiectasias are usually
secondary to either connective tissue diseases (sclero-
derma and telangiectoid variant of discoid lupus erythe-
matosus), as a component of poikiloderma atrophicans
vasculare (PAV), or rarely as a variant of sarcoidosis
known as angiolupoid sarcoid. Telangiectasia (mat-like
broad macules that are polygonal in shape and 1–2 mm
across) occurring primarily on the hands and face are a
prominent feature in scleroderma. They are present in the
majority of patients in association with loss of cutaneous
elasticity and hardening of the skin (sclerosis). These
changes represent microvascular and fibrous changes
inherent in the scleroderma disease process, respectively.15
Mould and Roberts-Thomson studied the correlation
between the amount of telangiectasia in scleroderma with
disease duration and found a significant correlation, par-
ticularly in the limited subtype; on the other hand, no
correlation was observed between the number of telangi-
ectasias with disease duration or nail-fold capillary diam-
eter in diffuse scleroderma or systemic sclerosis.16
Although mat-like telangiectasias arise from dilatation of
International Journal of Dermatology 2015, 54, e294–e301
e298 Report Diagnosing patients with localized telangiectasia
post-capillary venules, sometimes they may involve dilata-
tion of dermal capillaries leading to diffuse erythematous
appearance, and thence clinicians should be aware that
an apparent acquired PWS may be an early manifestation
of localized morphea.17
In 1888, Radcliffe Crocker18 first described a telangiec-
tatic form of lupus erythematosus characterized by sym-
metric persistent circumscribed patches on both cheeks,
which on palpation were decidedly thickened and shot
through with dilated blood vessels. The extensor surface
of the hands was the seat of patchy persistent erythema,
resembling chilblain, which after involution showed atro-
phic scarring. According to Crocker, the patches on the
cheek simulated the red paint on a clown’s face. Under
the term erysipelas perstans faciei, Kaposi,19 in 1872, also
brought attention to the deep red patches on the face
with purpura preceding the onset of lupus erythematosus
acutus disseminatus. Lupus erythematosus telangiectoides
is a variant of disseminated discoid lupus erythematosus,
characterized by a persistent, blotchy, reticulate telangiec-
tasia, which occurs on the face, neck, ears, dorsa of the
hands, breasts, heels, and on the sides of the feet.20 Cases
with localized lesions are on record.21,22 Other disorders
with telangiectasia on the face such as rosacea, carcinoid,
seborrheic dermatitis, hereditary hemorrhagic telangiecta-
sia (history of oro-nasal bleed and involvement of
mucosa), and bloom syndrome (history of photosensitivi-
ty) may be differentiated by the absence of skin atrophy.
Facial telangiectasia due to prolonged steroid application
(history of topical application of high potency steroid)
and angiolupoid sarcoidosis can be differentiated by clas-
sical histologic findings. The histology of this type of
lesion shows an atrophic epidermis, with dilatation of the
superficial vessels of the skin and slight infiltration of the
papillary part of the corium. Vacuolization of basal cells
and thickening of the basement membrane helps in mak-
ing the diagnosis.
Poikiloderma is a morphologic and descriptive term
referring to a combination of cutaneous atrophy, telangi-
ectasia, and varied macular pigmentary changes that
result in a mottled skin appearance. Its etiology includes
both congenital and acquired causes. PAV is characterized
by one or a limited number of patches (composed of tel-
angiectasia, atrophy, and hyper/hypopigmentation) espe-
cially over the breasts or buttocks (limb girdle area). It
may be an idiopathic disorder or a manifestation of con-
nective tissue diseases (lupus, dermatomyositis, sclero-
derma), lymphomas (parapsoriasis en plaques and
mycosis fungoides), and genodermatoses (Rothmund–
Thomson syndrome, hereditary sclerosing poikiloderma,
dyskeratosis congenita). Other causes include physical
trauma (radiodermatitis, burns, freezing) and certain
ingested substances such as arsenic compounds. Hence, in
International Journal of Dermatology 2015, 54, e294–e301
Gupta et al.
a case of PAV, the spectrum of investigations should
include tests for any underlying systemic disease, lym-
phoma, or connective tissue disorder.23 Old age and
refractoriness to treatment should raise the suspicion of
premalignant PAV. When no underlying condition is
found on multiple skin biopsies, the condition is labeled
as sclerodermiform plaque-like essential telangiectasias or
Brocq’s telangiectasias. Recently, an etiological classifica-
tion with the key differentiating features for each individ-
ual cause, to help in making a precise diagnosis of
different causes and a step-by-step approach to the man-
agement of patients with acquired poikiloderma, has been
described in detail in the literature.24
Sarcoidosis is a multisystem granulomatous disorder
with protean manifestations ranging from self-limited skin
lesions to intractable organ failure. Among the protean
manifestations of cutaneous sarcoidosis, including macu-
lopapules, nodules, plaques, subcutaneous nodules, infil-
trative scars, and lupus pernio, the angiolupoid
sarcoidosis is a rarely reported variant characterized by
erythematous plaques with superficial telangiectasia on
the face, particularly in paranasal areas. It results in
severe disfigurement and can cause profound social
embarrassment. Since its first description in 1913, only a
few cases had been reported in the English language liter-
ature.25 Tsai et al.26 reviewed the dermatological files in
Chang Gung Memorial Hospital over 16 years and found
only eight cases with consistent features of angiolupoid
sarcoidosis. They suggested that angiolupoid sarcoidosis
is a rare but real variant of sarcoidosis. Interestingly, the
incidence of pulmonary and ocular involvement is report-
edly low.26–28 However, more cases are needed to con-
firm the optimistic conclusions. In spite of being
asymptomatic, treatment of angiolupoid sarcoidosis is
imperative due to the severe disfigurement disturbing the
patients. Although diverse methods of treatment have
been tried, including the systemic, topical, and intrale-
sional glucocorticoids, doxycycline, hydroxychloroquine,
and antituberculosis agents, none of them are definitive.
The differential diagnosis of angiolupoid sarcoidosis
includes lupus pernio, chilblain lupus erythematosus, and
mycobacterial (including leprosy) and fungal infections.
Hitherto, the natural progression of lesion along with the
histopathological features is of utmost importance in
making one diagnosis over another. Lupus pernio charac-
teristically involves the tip of the nose, does not show any
tendency of resolution, and is associated with severe pul-
monary involvement. Angiolupoid variant, on the other
hand, is distinctive with predominant involvement of the
cheeks and relative absence of systemic involvement. In
addition, the presence of multiple dilated blood vessels
in the papillary dermis in addition to paucilymphocytic
non-caseating granulomas is enough to differentiate it
ª 2015 The International Society of Dermatology
Gupta et al.
from other granulomatous diseases. Similarly, chilblain
lupus and infectious causes can be easily differentiated by
the presence of hydropic degeneration of basal cells and
the infectious organisms, respectively.
Topical corticosteroid-induced rosacea-like dermatitis
(TCIRD) is an entity that starts after discontinuing potent
topical corticosteroid after its application for a consider-
able time. It is a rebound phenomenon, which usually
appears on the face in a perioral, diffuse, and centrofacial
distribution. It may or may not be associated with skin
atrophy. The majority presents with a history of exacer-
bation of symptoms after sun exposure, most probably
due to atrophy and vasodilatation of the facial skin. Inter-
estingly, eye problems are reportedly absent.29 Treatment
involves a fine balance between gradual tapering to com-
plete cessation of the topical steroid and addition of oral
anti-inflammatory antibiotics and/or topical antibiotics.
Secondary telangiectasia without skin atrophy
Conditions such as TMEP, rosacea, carcinoid, seborrheic
dermatitis, and hereditary hemorrhagic telangiectasia
(HHT) present with linear telangiectasia on the face with-
out any skin atrophy. TMEP is a rare form of cutaneous
mastocytosis characterized by multiple symmetrically
scattered telangiectatic macules primarily involving the
trunk, extremities, or face. Histologically, minimal mono-
nuclear infiltrate, containing mast cells around the capil-
laries, are characteristic. Special stains, such as Giemsa or
toluidine blue, highlight the presence of mast cells, reveal-
ing their metachromatic cytoplasmic granules. Unilateral
TMEP over the face30,31 and breast32 have been reported
previously, and to our knowledge, the illustrated case of
linear unilateral TMEP involving the lateral wall of the
axilla (T2 dermatome) in this review has never been
reported. In such unusual cases, it is all the more important
to have a systematic approach to avoid misdiagnosis.
Association with flushing and systemic symptoms such
as diarrhea should raise the suspicion of carcinoid syn-
drome, which is seen in 5% of cases with carcinoid
tumors of the gastrointestinal tract. Rosacea usually has a
typical unmistaken distribution and morphology. Associa-
tion with dandruff and yellow greasy scales are a pointer
towards seborrheic dermatitis. Similarly, telangiectasia
mainly over the lips and oral mucosa and sometimes on
the face and dorsum of the hands in association with a
nosebleed are seen in HHT. It is characterized by the
presence of multiple arteriovenous malformations.
Although HHT is a developmental disorder, caused due
to mutation in germline genes, endoglin, and ALK-1,
infants are occasionally affected. In most people, the fea-
tures are age-dependent, and the diagnosis is not sus-
pected until adolescence or later. Small arteriovenous
malformations (telangiectasias) close to the surface of the
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Diagnosing patients with localized telangiectasia Report e299
skin, and mucous membranes often rupture and bleed
after slight trauma. The most common clinical manifesta-
tion is spontaneous and recurrent nosebleeds (epistaxis)
beginning on average at age 12 years.33
Conclusion and recommendations
As even benign-looking telangiectasias can be a marker of
underlying systemic disease and result in profound disfig-
urement, picking the correct diagnosis out of the basket
requires a systematic approach. When associated with
skin atrophy, most telangiectasias are secondary in origin.
Although history and location of lesion are usually help-
ful in elucidating the correct diagnosis in disorders with
primary telangiectasia, most secondary telangiectasias
require a skin biopsy for final confirmation. Patients with
potentially more serious conditions such as PAV need
observation and multiple biopsies before the diagnosis of
cutaneous T-cell lymphoma is ruled out.
Although treatment results may not be permanent for most
of these cases, for cosmetically sensitive areas of the body,
gentle cautery can be used for a small number of lesions.
Laser therapy is also an effective treatment and can be useful
in those having a larger number of lesions. We treated our
patient with pulsed dye laser (585 nm, at 2 maximum) for
three months, but it failed to improve her eruptions.
Multiple choice questions
1 Macular telangiectasias most commonly arise from
which part of the cutaneous vasculature
a Capillary
b Postcapillary venules
c Small collecting veins
d Precapillary arterioles
2 All of the following conditions mostly involve above
the waist area except
a Acquired nevoid telangiectasia
b Stork bite
c Angioma serpinginosum
d Costal fringe
3 In which of the following conditions are telangiectasias
are associated with skin atrophy?
a Purpura annularis telangiectoides
b Rosacea
c Brocq’s telangiectasia
d Spider nevi
4 All of the following are true about telangiectasia mac-
ularis eruptiva perstans except
a Most common form of cutaneous mastocytosis
b Characterized by red tan macules less than 0.5 cm
in diameter
c Most common site of involvement is upper trunk
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e300 Report Diagnosing patients with localized telangiectasia
d Skin biopsy is diagnostic
5 Telangiectasias associated with high estrogenic states
are seen in_______?
a Acquired nevoid telangiectoides
b Spider nevi
c Both a and b
d Costal fringe
e All of the above
6 Treatment of localized telangiectasias include
a Pulsed dye laser
b Electrocautery
c Sclerotherapy
d All of the above
7 Which of the following items are false regarding Poi-
kiloderma atrophicans vasculare?
a Characterized by a localized patches of telangiecta-
sias, atrophy, and reticulate pigmentation
b Associated with internal or cutaneous malignancy
c Association with malignancy is more likely when
atrophy is absent
d None of the above
8 Medial telangiectatic nevus is
a A capillary malformation
b An acquired tumor of blood vessels in glabellar
region
c Usually associated with skin atrophy
d Self-limiting
9 All of the following are categorized into secondary tel-
angiectasia except
a Telangiectasia macularis eruptiva perstans
b Rosacea
c Spider nevi
d Poikiloderma of Civatte
10 Localized telangiectasia on upper chest in a young
male
a Should be screened for HIV infection
b Should always undergo skin biopsy
c Needs no investigation and patient should be coun-
seled
d Should be treated with sunscreen and pulsed dye
laser
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2009; 15: 44–48.
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