Tumor like vascular lesions
Tumor like vascular lesions
Updated: 06/23/2025
© Jun Wang, MD, PhD
Vascular malformations
- Salmon patch
- AKA nevus simplex
- Usually head and neck
- More common in face and neck
- Small pink or red patches with poorly defined borders
- Persistent macular erythema
- Dilated dermal vessels, malformation, usually regress
- Clinical diagnosis
- Port-wine stain
- AKA nevus flammeus
- Flat, pink, red to purple
- Well demarcated
- May grow with age and thicken the skin surface
- If in distribution of trigeminal nerve may be associated with Sturge-Weber syndrome
- Clinical diagnosis
Vascular ectasias
- Localized dilation of preformed vessels
- Spider telangiectasia
- Radial, pulsatile array of dilated subcutaneous arteries or arterioles around a central core
- May be associated with hyperestrinism as seen in cirrhosis
- Hereditary hemorrhagic telangiectasia
- AKA Osler-Weber-Rendu disease
- Autosomal dominant
- Mutation of TGF-beta signaling pathway (ENG, ALK1/ACVRL1, etc)
- Telangiectasia associated with endothelial cell junction abnormalities, endothelial cell degeneration, and weakness of the perivascular connective tissue
- Common presentations include epistaxis, telangiectasia, anemia, especially iron-deficiency anemia, etc
- Most commonly involves skin and mucosa
- Irregular collection of blood vessels
- Localized capillary dilation with arterial blood shunted directly into postcapillary venules
Bacillary angiomatosis
- Reactive vascular proliferation
- Commonly associated with opportunistic infection of immunocompromised
- More common in men, HIV +
- Infection with Bartonella species (Gram negative rods)
- Clinical presentations
- Fever, chills, malaise, headache, anorexia
- With or without weight loss
- Skin manifestations: Variable, commonly papular, pedunculated ro verrucous growth
- Vascular proliferation with neutrophilicinfiltration, bacteria detected with silver stain
- Treatment: antibiotics
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