Cherry angioma
Encyclopedia
Cherry angiomas, also known as Campbell De Morgan spots or Senile angiomas, are cherry red
papules on the skin containing an abnormal proliferation of blood vessels. They are the most common kind of angioma
. They are called Campbell de Morgan spots after the nineteenth-century British
surgeon
Campbell De Morgan
, who first noted and described them.
The frequency of cherry angiomas increases with age.
at the surface of the skin
, forming a small round dome ("papule
"), which may be flat topped. They range in colour from bright red
to purple
. When they first develop, they may be only a tenth of a millimeter in diameter and almost flat, appearing as small red dots. However, they then usually grow to about one or two millimeters across, and sometimes to a centimeter or more in diameter. As they grow larger, they tend to expand in thickness, and may take on the raised and rounded shape of a dome
. Multiple adjoining angiomas are said to form a polypoid angioma. Because the blood vessel
s comprising an angioma are so close to the skin's surface, cherry angiomas may bleed
profusely if they are injured.
The first study trying to bring light to the molecular and genetic mechanisms behind cherry/senile hemangioma was recently published. The study found that the level of MicroRNA 424 is significantly reduced in senile hemangiomas compared to normal skin resulting in increased protein expression of MEK1 and Cyclin E1
. By inhibiting mir-424 in normal endothelial cells they could observe the same increased protein expression of MEK1 and Cyclin E1
which, important for the development of senile hemangioma; induced cell proliferation of the endothelial cells. They also found that targeting MEK1 and Cyclin E1
with small interfering RNA
decreased the number of endothelial cells.
Chemicals and compounds that have been seen to cause cherry angiomas are mustard gas, 2-butoxyethanol
, bromides and cyclosporine. A correlation has been seen between cherry hemangiomas and activity of the enzyme carbonic anhydrase
as well as a significant increase in the density of mast cells in cherry hemangiomas compared with normal skin.
or electrosurgery
have been used. More recently pulsed dye laser or Intense Pulsed Light
(IPL) treatment has also been used.
Future treatment based on a locally acting inhibitor of MEK1 and Cyclin E1
could possibly be an option. A natural MEK1 inhibitor is Myricetin
Red
Red is any of a number of similar colors evoked by light consisting predominantly of the longest wavelengths of light discernible by the human eye, in the wavelength range of roughly 630–740 nm. Longer wavelengths than this are called infrared , and cannot be seen by the naked eye...
papules on the skin containing an abnormal proliferation of blood vessels. They are the most common kind of angioma
Angioma
Angiomas are benign tumors derived from cells of the vascular or lymphatic vessel walls or derived from cells of the tissues surrounding these vessels....
. They are called Campbell de Morgan spots after the nineteenth-century British
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
surgeon
Surgeon
In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...
Campbell De Morgan
Campbell De Morgan
Campbell Greig De Morgan was a British surgeon who first speculated that cancer arose locally and then spread, first to the lymph nodes and then more widely in the body...
, who first noted and described them.
The frequency of cherry angiomas increases with age.
Characteristics
Cherry angiomas are made up of clusters of capillariesCapillary
Capillaries are the smallest of a body's blood vessels and are parts of the microcirculation. They are only 1 cell thick. These microvessels, measuring 5-10 μm in diameter, connect arterioles and venules, and enable the exchange of water, oxygen, carbon dioxide, and many other nutrient and waste...
at the surface of the skin
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
, forming a small round dome ("papule
Papule
A papule is a circumscribed, solid elevation of skin with no visible fluid, varying in size from a pinhead to 1 cm.With regard to the quote "...varying in size from a pinhead to 1cm," depending on which text is referenced, some authors state the cutoff between a papule and a plaque as 0.5cm,...
"), which may be flat topped. They range in colour from bright red
Red
Red is any of a number of similar colors evoked by light consisting predominantly of the longest wavelengths of light discernible by the human eye, in the wavelength range of roughly 630–740 nm. Longer wavelengths than this are called infrared , and cannot be seen by the naked eye...
to purple
Purple
Purple is a range of hues of color occurring between red and blue, and is classified as a secondary color as the colors are required to create the shade....
. When they first develop, they may be only a tenth of a millimeter in diameter and almost flat, appearing as small red dots. However, they then usually grow to about one or two millimeters across, and sometimes to a centimeter or more in diameter. As they grow larger, they tend to expand in thickness, and may take on the raised and rounded shape of a dome
Dome
A dome is a structural element of architecture that resembles the hollow upper half of a sphere. Dome structures made of various materials have a long architectural lineage extending into prehistory....
. Multiple adjoining angiomas are said to form a polypoid angioma. Because the blood vessel
Blood vessel
The blood vessels are the part of the circulatory system that transports blood throughout the body. There are three major types of blood vessels: the arteries, which carry the blood away from the heart; the capillaries, which enable the actual exchange of water and chemicals between the blood and...
s comprising an angioma are so close to the skin's surface, cherry angiomas may bleed
Bleeding
Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood or blood escape from the circulatory system...
profusely if they are injured.
Cause
Cherry angiomas appear spontaneously in many people in middle age but can also, although less common, occur in young people. They can also occur in an aggressive eruptive manner in any age. The underlying cause for the development of cherry angiomas is not understood, much because of a lack of interest in the subject. This is probably because they rarely are caused by an internal malignancy.The first study trying to bring light to the molecular and genetic mechanisms behind cherry/senile hemangioma was recently published. The study found that the level of MicroRNA 424 is significantly reduced in senile hemangiomas compared to normal skin resulting in increased protein expression of MEK1 and Cyclin E1
Cyclin E1
G1/S-specific cyclin-E1 is a protein that in humans is encoded by the CCNE1 gene.-Interactions:Cyclin E1 has been shown to interact with Retinoblastoma-like protein 2, Cdk1, CDC25A, Cyclin-dependent kinase 2, SMARCA4, CDKN1B, HERC5, CUL3 and P21....
. By inhibiting mir-424 in normal endothelial cells they could observe the same increased protein expression of MEK1 and Cyclin E1
Cyclin E1
G1/S-specific cyclin-E1 is a protein that in humans is encoded by the CCNE1 gene.-Interactions:Cyclin E1 has been shown to interact with Retinoblastoma-like protein 2, Cdk1, CDC25A, Cyclin-dependent kinase 2, SMARCA4, CDKN1B, HERC5, CUL3 and P21....
which, important for the development of senile hemangioma; induced cell proliferation of the endothelial cells. They also found that targeting MEK1 and Cyclin E1
Cyclin E1
G1/S-specific cyclin-E1 is a protein that in humans is encoded by the CCNE1 gene.-Interactions:Cyclin E1 has been shown to interact with Retinoblastoma-like protein 2, Cdk1, CDC25A, Cyclin-dependent kinase 2, SMARCA4, CDKN1B, HERC5, CUL3 and P21....
with small interfering RNA
Small interfering RNA
Small interfering RNA , sometimes known as short interfering RNA or silencing RNA, is a class of double-stranded RNA molecules, 20-25 nucleotides in length, that play a variety of roles in biology. The most notable role of siRNA is its involvement in the RNA interference pathway, where it...
decreased the number of endothelial cells.
Chemicals and compounds that have been seen to cause cherry angiomas are mustard gas, 2-butoxyethanol
2-Butoxyethanol
2-Butoxyethanol is an organic solvent with the formula BuOC2H4OH . It is a colorless liquid with a sweet, ether-like odour. It is a butyl ether of ethylene glycol...
, bromides and cyclosporine. A correlation has been seen between cherry hemangiomas and activity of the enzyme carbonic anhydrase
Carbonic anhydrase
The carbonic anhydrases form a family of enzymes that catalyze the rapid interconversion of carbon dioxide and water to bicarbonate and protons , a reversible reaction that occurs rather slowly in the absence of a catalyst...
as well as a significant increase in the density of mast cells in cherry hemangiomas compared with normal skin.
Treatment
On the rare occasions that they require removal, traditionally cryosurgeryCryosurgery
Cryosurgery is the application of extreme cold to destroy abnormal or diseased tissue. The term comes from the Greek words cryo and surgery meaning "hand work" or "handiwork"....
or electrosurgery
Electrosurgery
Electrosurgery is the application of a high-frequency electric current to biological tissue as a means to cut, coagulate, desiccate, or fulgurate tissue. . Its benefits include the ability to make precise cuts with limited blood loss...
have been used. More recently pulsed dye laser or Intense Pulsed Light
Intense pulsed light
Intense pulsed light , is a technology aimed at producing light of high intensity during a very short period of time. It involves specific lamps together with capacitors whose rapid discharge provides the high energy required....
(IPL) treatment has also been used.
Future treatment based on a locally acting inhibitor of MEK1 and Cyclin E1
Cyclin E1
G1/S-specific cyclin-E1 is a protein that in humans is encoded by the CCNE1 gene.-Interactions:Cyclin E1 has been shown to interact with Retinoblastoma-like protein 2, Cdk1, CDC25A, Cyclin-dependent kinase 2, SMARCA4, CDKN1B, HERC5, CUL3 and P21....
could possibly be an option. A natural MEK1 inhibitor is Myricetin
Myricetin
Myricetin is a naturally occurring flavonol, a flavonoid found in many grapes, berries, fruits, vegetables, herbs, as well as other plants. Walnuts are a rich dietary source. Trace amounts can be found as glycosides. It is one of the phenolic compounds present in red wine.Myricetin has antioxidant...
Prognosis
In most patients, the number and size of cherry angiomas increases with advancing age. They are harmless, except in very rare cases that involve a sudden appearance of many angiomas, which can be a sign of a developing internal malignancy.External links
- Netdoctor UK Dr John Pillinger. GP
- HealthScout
- FPNotebook
- MedSapiens
- eMedicine with picture showing small red dots