Small surface nodules may be excised individually or destroyed by electrocoagulation. A bright red, faintly pulsatile vascular lesion consisting of a central arteriole with slender projections resembling spider legs. Spider angiomas are not congenital. One lesion or small numbers that are unrelated to internal disease may occur in children or adults. Most patients with hepatic cirrhosis develop many spider angiomas that may become quite prominent.
Many women develop lesions during pregnancy or while taking oral contraceptives.
The lesions are asymptomatic and usually resolve spontaneously about 6 to 9 mo postpartum or after oral contraceptives are discontinued. Compression of the central vessel temporarily obliterates the lesion. Treatment is not usually required. If resolution is not spontaneous or treatment is required for cosmetic purposes, the central arteriole can be destroyed with laser treatment, which produces a superior cosmetic result compared with fine-needle electrodesiccation. Puncture of the lesion yields a colorless fluid.