Angiomas

An angioma is a benign lesion characterized by an abnormal proliferation of blood vessels, and less commonly lymphatic vessels. The term covers a range of conditions, including vascular tumors such as hemangiomas and vascular malformations, which may be present at birth or develop later in life. Angiomas are usually harmless, but some types can cause functional, cosmetic, or other complications depending on their size and location.

Common examples seen in adults include cherry angiomas, small bright red papules that tend to multiply with age; spider angiomas, which have a central arteriole with radiating capillaries and can appear with hormonal changes or liver disease; and strawberry or infantile hemangiomas, which typically occur in infants as raised red plaques or nodules and may involute over time. The terminology can be confusing, as “hemangioma” is typically used for proliferative vascular tumors, while “angioma” is a broader umbrella term.

Infantile hemangiomas usually appear within weeks of birth, undergo a rapid growth phase, and then slowly involute over years. Most require no treatment, but lesions that threaten function, ulcerate, or cause significant cosmetic concern may respond to therapies such as oral propranolol, corticosteroids, and, in some cases, laser treatment or surgery.

Evaluation often relies on clinical examination. Imaging, such as duplex ultrasound, MRI, or CT, is reserved for lesions with deep extent or suspicion of a malformation. Differential diagnoses include angiokeratomas, pyogenic granuloma, venous lakes, and other vascular or pigmented lesions; biopsy is rarely necessary.

Prognosis is generally excellent for benign angiomas. Vascular malformations tend to persist and may require multidisciplinary management with laser therapy, sclerotherapy, embolization, or surgical intervention.