As is well known, spider nevus consists of a central dilated capillary loop of the papillary layer of the skin, and from this radiate dilated capillaries, giving rise to its spider-like or starlike appearance. It is a harmless deformity, but frequently disfiguring, especially when it occurs on the tip of the nose. At times there is more than one central dilated capillary in the same red spot. I have seen three. They must all be treated to secure a perfect result.
The treatment consists in obliterating the central capillary. Sometimes this capillary is fairly distinct, sometimes not. Whether distinct or not, however, the diffusion of light by the superimposed epithelial layers, especially by the horny layer, always interferes with its being perfectly distinct. Furthermore, these layers intervene in any endeavor to introduce the electric needle, the hot point or the chemical employed to obliterate the central dilated capillary.
MONTGOMERY DW. TREATMENT OF SPIDER NEVUS. Arch Derm Syphilol. 1933;27(6):971–972. doi:10.1001/archderm.1933.01450040981009
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