82 W. B. Bean 



are produced in great quantity. Since approximately 10 

 per cent of normal persons may have one or more vascular 

 spiders their clinical significance is important only when there 

 are many, when new ones appear or when they enlarge. Age: 

 The eruptive spider naevi occur in the childbearing period in 

 women and in the cirrhotic patients mostly in the thirties 

 and forties. There is no apparent relation to age per se. They 

 occur in very young or very old persons. 



Palmar erythema as an acquired vascular change in the 

 skin has the same backgound, course and age incidence as 

 spider nsevi. The relationship to hypercestrinaemia is not 

 so close though there is the same clinical background. 



Venous Stars 



As the name implies the venous star (Fig. 1) is a stellate 

 system of collecting veins visible in the skin and larger than 

 those in normal skin. They are small varicose veins, vari- 

 cules, appearing usually upstream in venous collecting 

 systems of the skin where pressure is regularly or intermit- 

 tently high. They are common on the lower legs and thighs 

 in association with larger varices. Blood flows from the 

 periphery to the centre, thence to an underlying collecting 

 vein. Such lesions may appear in large numbers over the 

 chest in persons with obstruction of the superior vena cava 

 during the period of development of collaterals. Age: Fig. 2 

 shows that as age increases many more persons are found to 

 have venous stars. There is a consistent tendency for more 

 women than men to be affected in any age group. This is 

 associated with the well known tendency for women to have 

 more and worse varicose veins than men. 



Cherry Angiomas 



There are many names for the cluster of small dilated 

 capillary vessels which form the characteristic bright red 

 ruby spot, De Morgan's spot, senile angioma or capillary 

 angioma. The size and shape vary but the typical spot is 



