Part 70

#Into what two classes may angiomata be roughly grouped?#

The flat (or non-elevated) and the prominent (or elevated).

#Describe the flat, or non-elevated, variety of angioma.#

The flat, or non-elevated, angioma (nævus flammeus, nævus simplex, angioma simplex, capillary nævus) may be pin-head- to bean-sized; or it may involve an area of several inches in diameter, and, exceptionally, a whole region. It is of a bright- or dark-red color, and is met with most frequently about the face. In some instances it extends after birth, reaches a certain size and then remains stationary; occasionally, when involving a small area, it undergoes involution and disappears.

The so-called port-wine mark is included in this group.

#Describe the prominent, or elevated, variety of angioma.#

The prominent variety (venous nvus, angioma cavernosum, nvus tuberosus) is variously-sized, often considerably elevated, clearly-defined, compressible, smooth or lobulated, and of a dark, purple color; it may, also, be erectile and pulsating. The growth is usually a single formation, and is met with upon all parts of the body.

#What is the pathology of angioma?#

It is a new growth, consisting of a variable hypertrophy of the cutaneous and subcutaneous arterial and venous bloodvessels, with or without an increase of the connective tissue.

#Give the treatment of angioma.#

In some instances, especially in infants, painting the parts repeatedly with collodion or liquor plumbi subacetatis will act favorably. For well-established, small, capillary nævi electrolysis or puncturing with a red-hot needle or with a needle charged with nitric acid may be employed; for "port-wine mark" frequent and closely contiguous electrolytic punctures are occasionally followed by a slight diminution in color. For the prominent growths, vaccination, the ligature, puncturing with the galvano-cautery, and excision are variously resorted to.

In recent years applications of liquid air and carbon dioxide have proved of service in some cases.

#Telangiectasis.#

#Describe telangiectasis.#

Telangiectasis consists of a new growth or enlargement of the cutaneous capillaries, usually appearing during middle adult life, and seated, for the most part, about the face.

#To what extent may telangiectasis develop?#

It may be limited to a red dot or point, with several small radiating capillaries (nævus araneus, spider nævus), or a whole region, usually the face, may show numerous scattered or closely-set capillary enlargements or new formations (rosacea). The latter is frequently associated with acne (acne rosacea).

The etiology is obscure.

#What is the treatment of telangiectasis?#

Destruction of the vessels by electrolysis or by the knife. (See treatment of acne rosacea.)

#Lymphangioma.# (Synonym: Lymphangiectodes.)

#Describe lymphangioma.#

Lymphangioma is a rare disease, consisting of localized dilatations of the lymphatic vessels, appearing as discrete or aggregated pin-head or pea-sized, compressible, hollow, tubercle-like elevations, of a pinkish or faint lilac color, and occurring for the most part about the trunk. It is of slow but usually progressive development, and is unaccompanied by subjective symptoms.

A rare condition, Kaposi described as lymphangioma tuberosum multiplex, characterized by more or less solid, somewhat cystic, pearly to pinkish red, sometimes crowded lesions, is now known to be "benign cystic epithelioma"; its most common site is the face. While called "benign," ulcerative action may eventually ensue.

Treatment, when demanded, consists of operative measures.

#Rhinoscleroma.#

#Describe rhinoscleroma.#

Rhinoscleroma is a rare and obscure disease, slow but progressive in its course, characterized by the development of an irregular, dense and hard, flattened, tubercular, non-ulcerating, cellular new growth, having its seat about the nose and contiguous parts. The overlying skin is normal in color, or it may be light- or dark-brown or reddish. Marked disfigurement and closure, partial or complete, of the nasal orifices gradually results. It is met with chiefly in Austria and Germany.