As cutaneous venous hypertension increases, so does the volume of intradermal telangiectasia. In fact, spider veins may become aneurysmal when the pressure increases substantially. Many times, these complexes are associated with large refluxing branches or turbulent flow in a perforator. The treatment consists of micro-surgical techniques for these patients. Many of these aneurysms must be extracted from the intradermal space.
Below is an image of mild aneurysmal dilation. The histology image shows marked dilation of the intradermal spider vein. Note the vein is compressed between the squamous epithelium and the reticular dermis below.
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