From the Guidelines
Multiple cherry hemangiomas are generally benign and have limited clinical significance, and no treatment is necessary unless they bleed, become irritated, or cause cosmetic concerns. These small, bright red papules are caused by an overgrowth of blood vessels in the skin and typically appear on the trunk and extremities. They become more common with age, with most adults over 30 having at least a few. While the presence of multiple cherry hemangiomas is usually not concerning, a sudden increase in their number or size may occasionally be associated with pregnancy, certain medications, or rarely, internal malignancies or liver disease 1, 2, 3, 4, 5.
Key Considerations
- The presence of multiple cherry hemangiomas is usually not concerning, but a sudden increase in their number or size may be associated with underlying conditions.
- No treatment is necessary for these lesions unless they bleed, become irritated, or cause cosmetic concerns.
- If treatment is desired, options include electrocautery, laser therapy, shave excision, or cryotherapy, all of which can be performed in an outpatient setting.
- Any cherry hemangioma that changes in appearance, bleeds spontaneously, or is associated with other concerning symptoms should be evaluated by a healthcare provider to rule out more serious conditions.
Management and Treatment
- Regular skin examinations are recommended for anyone with multiple skin lesions of any type.
- Treatment options should be individualized based on the patient's specific needs and concerns.
- Hemangioma specialists may have expertise in various medical and surgical specialties, and their practice is often focused primarily or exclusively on the pediatric age group 5.
Clinical Significance
- Multiple cherry hemangiomas are generally benign and have limited clinical significance.
- However, a sudden increase in their number or size may be associated with underlying conditions, and any changes in appearance or symptoms should be evaluated by a healthcare provider.
- The clinical significance of multiple cherry hemangiomas should be evaluated on a case-by-case basis, taking into account the patient's individual needs and concerns.
From the Research
Clinical Significance of Multiple Cherry Hemangiomas
- Multiple cherry hemangiomas can be a presenting sign of underlying systemic diseases, such as multicentric Castleman disease (MCD) 6.
- The sudden onset of multiple cherry hemangiomas, also known as eruptive cherry hemangiomatosis, can be associated with lymphoproliferative diseases 6.
- In some cases, multiple cherry hemangiomas may be a benign condition, but it is essential to evaluate and follow up on patients presenting with this condition, especially if they have systemic symptoms or lymphadenopathy 6.
Treatment Options for Cherry Hemangiomas
- Various treatment modalities exist for cherry hemangiomas, including laser therapy and non-laser therapy 7.
- Laser therapies, such as pulsed dye laser (PDL), potassium-titanyl-phosphate (KTP) laser, and neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, can be effective in treating cherry hemangiomas 7, 8, 9.
- Non-laser therapies, including cryotherapy, sclerotherapy, electrosurgery, and radiofrequency ablation, can also be used to treat cherry hemangiomas 7.
- The choice of treatment modality may depend on the individual patient's condition, skin type, and preferences 7, 8.
Potential Complications of Treatment
- Treatment of cherry hemangiomas with laser therapy can be associated with complications, such as pigmentary changes, especially in darker-skinned individuals 7, 10.
- Pyogenic granuloma is a rare complication that can occur after pulsed-dye laser therapy for cherry angioma 10.
- Electrosurgery and other non-laser therapies can also cause textural changes and other complications 8.