What are cutaneous hemangiomas?

Hemangiomas, also called angiomas, are small lesions caused by the presence of a high number of blood vessels. They are considered a benign neoplasm caused by abnormal growth of endothelial cells of blood vessels.

Hemangiomas can appear in many parts of the body, such as the hepatic hemangiomas, vertebral hemangiomas, or cutaneous hemangiomaseach with a different etiology.

In the specific case of cutaneous hemangiomas, they are usually more frequent on the trunk and appear as small formations on the skin with a flat or slightly raised surface. Its shape is highly variable and the color can range from bright red to black.

They usually start dating in middle age, around thirty, and their number tends to increase with advancing age, which is why they are also called senile hemangiomas. They are usually completely benign and do not need treatment although they can be removed with various methods if necessary or if they wish to remove for cosmetic reasons.

What do they look like?

At first they can be very small red spotslike the head of a pin, and are often called «red freckles«. They can get bigger over time and reach more than half a centimeter in diameter. The smallest ones are almost always flat while the largest have raised relief.

Although the most common color is red of different shades, it can vary considerably, from a bright red to a purple almost black. Sometimes they are bluish and there are also dark brown ones.

Where do they appear?

Hemangiomas can appear anywhere in the body but are most common on the trunk, especially in the torso. They are rare in hands, feet and near mucous membranes.

Being mostly benign neoplasms, the place where they appear is very important when deciding whether to treat them or not. One of the main reasons for treatment is estheticespecially when the hemangiomas are bulky, large and appear in visible areas such as the face and neck.

The other most common reason for treatment is when they appear in areas subject to continuous friction, for example those that appear on the neck in the area of ​​the edge of the shirts; this friction can make hemangiomas bleed and be quite annoying.

When and how many appear?

These lesions can appear at any age but usually begin to appear after the age of 30 and affect men and women equally. Although observations reveal that they are equally common in people of any race and ethnic origin, in people with brown and dark skin they can go unnoticed, which is why hemangiomas are typically associated with Caucasians or white people.

The number of hemangiomas tends to increase with advancing age, in fact they were previously known as senile angiomas, although this term is already being avoided because it is an injury that is not at all related to loss of mental functions to which refers to the term senile.

What they owe?

The causes are not exactly known. Some experts believe they may be related to genetic factorssince in the cells of the hemangioma it is common a decreased microRNA 424a non-coding RNA molecule involved in gene expression.

It is also common in hemangiomas to find high levels of mast cellscells of the immune system present in the connective tissue that are involved in inflammatory and allergic processes.

As in many other diseases and conditions, it could be that there is a genetic predisposition but with a great influence of the environment in its expression.

When to go to the doctor?

In the vast majority of cases, hemangiomas are completely benign and are not a cause for concern. However, if you see a sudden change in number, color, size, or shape, or if they become painful, tender, or itchyyou should go to the doctor to evaluate them and determine if you need treatment or not.

These sudden changes are usually a sign of other problems that can be quite serious, such as skin cancer, although it is usually more associated with brown and black spots.

How are they treated?

Most patients who want to remove hemangiomas from their skin do so for aesthetic reasons or because they are in uncomfortable places. If they are small, the dermatologist can remove them by cautery, cryotherapy, or laser. These treatments are usually quick, just a few minutes, and with excellent results, although a scar may appear, especially if the hemangiomas are large.

It is not recommended to try to remove hemangiomas at home because they can bleed a lot and there is a risk of infections. In addition, it is also important that the doctor rule out other more serious problems.

In case of large or very numerous hemangiomas, a major surgical intervention may be necessary.

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