Alternative Names : Cherry hemangioma, Senile angiomas
Definition:
Campbell de Morgan spots are made up of clusters of tiny capillaries 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 vessels comprising an angioma are so close to the skin’s surface, cherry angiomas may bleed profusely if they are injured.
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These small red or violet spots most often appear on the chest or trunk and are nothing to worry about. They’re small, benign (non-cancerous) overgrowths of blood vessels in the skin. Medically, they’re called haemangioma or just angioma. Why they develop in the first place isn’t known. They’re usually less than 6mm in diameter and if pressed do not blanch.
They are the most common kind of angioma.They are called cherry angioma because of their colour, or senile angioma because they appear as a person gets older – usually first appearing after the age of 40 and increasing with age.
They are called Campbell de Morgan spots, after the nineteenth-century British surgeon Campbell De Morgan who first noted and described them.
Cherry angiomas occur in all races, ethnic backgrounds, and both sexes.
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Experts agree they’re best left alone since they’re harmless. However, some people do find them cosmetically unacceptable and wish to have them removed.
Symptoms:
Skin lesion or growth:
•Bright cherry-red
•Small — pinhead size to about 1/4 inch in diameter
•Smooth
Cause:
Campbell de Morgan spots 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. 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 Campbell de Morgan spots 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.
A recent study suggests that Prichard’s structures are the cardiac equivalent of cutaneous senile angioma. The study describes Prichard’s structures in the heart as “adult, fully differentiated, postmitotic-type endothelial cells with virtually no turnover.” and that these cells are senescent cells that “arrest growth and cannot be stimulated to re-enter the cell cycle by physiological mitogens; they become resistant to apoptotic cell death; and they acquire altered functions.”. The study concludes that Prichard’s structures are formed by “infolding of the endothelial lining of the endocardium of the fossa ovalis as an irritational response to altered blood flow, eddies or turbulence.”
Diagnosis:
Doctors probably diagnose a cherry angioma based on the appearance of the growth. No further tests are usually necessary, though a skin biopsy may be used to confirm the diagnosis.
Treatment:
On occasions that they require removal, traditionally cryosurgery 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.
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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.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Resources:
http://www.bbc.co.uk/health/physical_health/conditions/campbellmorganspots.shtml
http://en.wikipedia.org/wiki/Cherry_hemangioma
http://www.nlm.nih.gov/medlineplus/ency/article/001441.htm
http://medsapiens.com/2009/03/07/cherry-hemangioma/
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One reply on “Campbell de Morgan spots”
Very informative. Thank you