Cherry Angioma vs Petechiae: Differences and Similarities

In this article, we will review the presentation, causes and treatments for two skin conditions: cherry angioma and petechiae. We will discuss the similarities and differences between these conditions.
Jakub Hantabal

Jakub Hantabal

Postgraduate student of Precision Cancer Medicine at the University of Oxford, and a data scientist.

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What is a cherry angioma?

Cherry angioma, also known as a Campbell de Morgan spot, is a common type of benign (non-cancerous) skin growth. It is made up of small blood vessels, giving it a reddish or purplish appearance [1, 2]. The growth is usually round or oval, measuring several millimeters in diameter [1]. Cherry angiomas often grow on the torso, arms, legs, and shoulders [2]. They are particularly prevalent in the older population, becoming more common with age [3].

These growths are not a cause for concern unless they bleed or suddenly change appearance, which may be an indicator of skin cancer [2] - if you notice a growth on your skin that appears odd, is irregular in shape and/or colour and/or is bleeding, it is important to promptly visit a dermatologist or a primary care doctor [2].

As cherry angiomas have a distinct appearance and presentation, diagnosis is fairly straightforward. The diagnosis is made through a physical examination by looking at the growth through a dermatoscope - a device similar to a camera used to look at skin lesions with illumination and magnification. Sometimes, should a more in-depth examination be needed, a doctor may decide to do a biopsy, which involves numbing the area with local anaesthesia and take a small sample of the lesion, or the whole lesion. The tissue is then examined under the microscope, with stains that allow for visualisation of certain molecules that help establish a diagnosis [2].

In some cases especially if there is a need to understand the organisation of blood vessels in the angioma, optical coherence tomography may also be used [4].

Cherry angiomas are harmless, so treatment is done mostly for cosmetic purposes. The treatment is focused on removing the whole lesion, and the procedure is usually very simple and is done in office under local anaeshthesia. Variety of approaches can be used, including cryotherapy (where the lesion is frozen with liquid nitrogen), electrocautery (the lesion is "burned off" with a tool utilising electrical current), or excision (cutting out the lesion). Laser can also be used, as well as sclerotherapy, where a substance that disrupts blood vessels is injected.

What are petechiae?

Petechiae are small coloured spots that appear on the skin, caused by small bleeding under the skin. They most commonly form on arms, legs and stomach, and can form on and around the eyelids and in the mouth.

Petechiae are purple, red or brown, and may change colour as they heal. An easy way to tell whether a coloured lesion on your skin is a rash or petechiae is that petechiae do not change colour when pressure is applied on the skin [5].

Petechiae are formed when capliaries (very small blood vessels) break open and blood leaks into the skin [5]. This can occur due to a variety of reasons, including strenuous activity (for instance, petechiae often appear after childbirth).

Infections and reactions to medications are also common causes of petechiae [5, 6]. Certain haematological conditions including thrombocytopenia, leukemias, some types of anemia, platelet dysfunction, coagulation disorders, and vascular diseases can also lead to the formation of petechiae [6].

Petechiae may also be a symptom of an underlying systemic health issue - they have been observed to be associated with chronic liver disease, lupus, or Ehlers-Danlos syndromes (EDS) [6]. Acute injuries, allergic reactions, and a vitamin K deficiency are also associated with the symptom of petechiae [6]. Additionally, petechiae have been observed in people with COVID-19, following the changes in blood coagulation mechanisms induced by the infection [6].

Jakub Hantabal

Jakub Hantabal

Jakub is a postgraduate student of Precision Cancer Medicine at the University of Oxford, and a data scientist. His research focuses on the impact of hypoxia on genetic and proteomic changes in cancer. Jakub also consults and collaborates with multiple institutions in the United Kingdom and Slovakia supporting research groups with advanced data analysis, and he also co-founded an NGO organising educational events in data science.