Cherry Angioma - Understanding the Causes, Symptoms, and Treatment

Introduction

Cherry angioma was first coined as Campbell De Morgan spots, named after a British surgeon Campbell Greig De Morgan, in the 1800s.Cherry angiomas are small, papular (mole-like) skin growth formed due to the proliferation of cells that line the blood vessels, making them true capillary angiomas. Cherry angiomas are benign (noncancerous) skin growth and harmless, except they may bleed if scratched or rubbed on.

Where Do Cherry Angiomas Form?

Cherry angiomas can form anywhere on the body but are mostly seen on the torso (chest, abdomen, pelvis, and back) or proximal extremities (arms, legs, and shoulders).

Who Is Prone to Cherry Angiomas?

Rarely found among children. Commonly seen in adults aged 30 and above and may increase in number with age. Males and females are equally affected. More noticed among fair-skinned individuals than individuals of color.

How Does Cherry Angioma Look?

Cherry angiomas often appear as multiple skin lesions and have the following features:

• Asymptomatic (no complaints from patients except aesthetic concerns).

• Color- bright to dark red color with a pale halo around it.

• If thrombosed (blood clot within the lesion), the color may change to blue, purple, or black.

• Shape- round or oval shaped.

• Size- ranges from the size of a pinhead up to 5 mm.

• Structure- flat, smooth, and blends with the skin or slightly elevated from the skin like a mole.

• Multiple lesions are found in multiple areas of the body.

• Tend to blanch when pressure is applied unless it is fibrotic.

What Is the Cause of Cherry Angioma?

There is no confirmed causative reason for cherry angioma. However, several studies have found a correlation between certain factors and cherry angioma, indicating it to be a causative factor.

• Age - This could be an age-related change in the body.

• Genetic mutation - Mutation of specific genes is found to cause vascular cell proliferation, which may cause such skin lesions.

• Pregnancy - Estrogen levels during pregnancy or postpartum may cause the growth of cherry angiomas. It may also be found in women shortly before menopause (perimenopausal).

Sudden eruptions of these cherry angiomas could be:

• Reaction to warts (grainy skin growth) or vitiligo (loss of skin color in patches) and medications (for example, nitrogen mustard).

• Reaction to medication for solid tumors (for example, Ramucirumab).

• Reaction to medications such as Cyclosporine.

• Reaction following a stem cell or bone marrow transplant (chronic- graft host disease).

• A sign of other lymphoproliferative disorders (for example, lymphocyte leukemia).

• Related to the herpes virus (HHV-8), the virus can induce cell proliferation similar to that seen in cherry angiomas.

How to Diagnose Cherry Angiomas?

Clinical features of the lesion are unique enough for a diagnosis. However, if need be, a skin biopsy can always confirm a cherry angioma to rule out the possibility of other similar skin lesions, such as spider angiomas.

How to Treat Cherry Angioma?

Cherry angiomas being harmless, do not require any treatment. However, a dermatologist can remove the skin lesion when the lesion is of aesthetic concern, or it starts changing color, size, texture, or is itchy, causing it to bleed.

What Are the Treatment Options for Cherry Angioma?

The treatment options for cherry angiomas include:

1. Excision: A superficial procedure where a scalpel is used to shave or cut (depending on the rise of the lesion) the cherry angioma after anesthetizing the area with local anesthesia. A bandage is put on to protect the open wound area for two days.

2. Electrocautery (Electrodessication): After anesthetizing the area of concern, the dermatologist cuts the blood supply of the lesion by burning the lesion using an electric pulse (heat) from an electric needle. Cherry angioma is then scrapped off. The area must be kept dry and clean to avoid infection for two days and later can be cleaned with soap and water.

3. Cryosurgery (Freezing): This procedure uses liquid nitrogen. When it comes to contact with a tissue, liquid nitrogen freezes it. Depending on the area treated, a clear or red blister will appear. Then, it turns into a scab (rough skin-like) and falls off within one to three weeks. Care must be taken to avoid infections. Individuals may experience pain for two to three days. The post-op recovery may be uncomfortable (pain and scarring).

4. Laser: Laser is best suited for noticeably red cherry angiomas. When the laser beam is targeted at the cherry angioma, the blood vessels in the lesion absorb the laser beam light, causing the blood vessel to break down and subsequently destroy the cherry angioma tissue.

It takes two to four weeks for the effect of the treatment to be noticed. Results vary from skin tone; some may require just a single sitting while others may require more. If the lesion is not red (thrombosed lesion) or very small, the laser beam is not absorbed enough to destroy the cherry angioma. Avoid sun exposure for two weeks post-laser therapy for better recovery and minimal side effects. Cherry angiomas seen during pregnancy or postpartum may reduce in size and disappear on their own.

Can Cherry Angiomas Be Removed at Home?

Many home remedies have been mentioned that claim to help remove or reduce the size of cherry angiomas. Some of them are as follows:

• Tea tree oil.

• Lavender oil.

• Castor oil.

• Apple cider vinegar.

• Iodine.

• Pin cauterization (heat metal pin to burn the lesion).

• Calcium bentonite clay (Pascalite).

• Dandelion roots.

Although easily accessible and convenient, using these remedies is highly discouraged. Only a doctor can confirm the diagnosis of cherry angioma. Treating the lesion with home remedies on the assumption that it is a cherry angioma may cause adverse side effects if the lesion is of aggressive nature.

Trying procedures (pin cauterization) at home, with or without a confirmed diagnosis of cherry angioma, may lead to complications such as bleeding, infections, and scarring if not done properly in sterile environments.

How to Prevent Cherry Angiomas?

Prevention of cherry angiomas may not be possible since the causative reason for cherry angiomas is not known. However, care may be taken to avoid medications responsible for alterations in the cell proliferations that may cause cherry angiomas to develop. Since the lesion increases with age, there is a possibility that cherry angiomas reoccur even after the successful removal of the lesions.

Conclusion

Cherry angioma may not be as sweet as it sounds. It is merely a harmless skin lesion with cosmetic concerns. Cherry angioma can easily be sorted with minimally invasive procedures, which leaves no scar. With treatment options that have good results, cherry angioma need not be a worry.