Cherry angioma

Cherry angiomas (also known as "De Morgan spots," and "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 also called senile angiomas or 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.

Characteristics
Cherry angiomas 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.

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 far from understood, much because of a lack of interest in the subject. This is probably due to the fact that they very rarely are caused by an internal malignancy. 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 to normal skin.

Treatment
On the rare 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.

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.

Epidemiology
Cherry angiomas occur in all races, all ethnic backgrounds, and both sexes.