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Patient Case: Campbell de Morgan Spots

Patient Case: Campbell de Morgan Spots

Discussion

A 52-year-old man presents to his dermatologist for a routine skin check. He has noticed multiple small, bright red spots on his chest and upper arms over the past few years. They are painless, non-itchy, and do not change in size or shape. He is concerned about whether they indicate an underlying health issue.

On examination, the dermatologist observes several well-defined, dome-shaped, cherry-red papules, each measuring 1-3 mm in diameter. They blanch with pressure and are scattered across his upper trunk. There are no associated symptoms such as bleeding, ulceration, or inflammation.

The dermatologist reassures the patient that these lesions, known as Campbell de Morgan spots or cherry angiomas, are benign vascular proliferations that commonly appear with aging. No treatment is necessary, but the patient is offered laser removal or electrocautery if he wishes to remove them for cosmetic reasons.

Questions
  1. What is the most likely diagnosis in this patient?
    a) Kaposi's sarcoma
    b) Cherry angiomas (Campbell de Morgan spots)
    c) Petechiae
    d) Telangiectasia
  2. Which of the following best describes Campbell de Morgan spots?
    a) Malignant vascular tumors
    b) Benign capillary proliferations
    c) Autoimmune skin lesions
    d) Infectious skin papules
  3. What is the most appropriate management for this patient?
    a) Surgical excision with biopsy
    b) Immediate chemotherapy
    c) Reassurance and optional cosmetic removal
    d) High-dose corticosteroid therapy
  4. Which of the following factors is most associated with the development of Campbell de Morgan spots?
    a) Aging
    b) Viral infections
    c) Chronic sun exposure
    d) Vitamin deficiency
Reveal answers

Answers

  1. (b) Cherry angiomas (Campbell de Morgan spots)
    • These lesions are benign vascular proliferations that commonly appear on the trunk and extremities with age. They are not associated with malignancy or systemic disease.
  2. (b) Benign capillary proliferations
    • Campbell de Morgan spots are harmless overgrowths of capillaries within the skin, giving them their characteristic red appearance. They are not infectious or immune-mediated.
  3. (c) Reassurance and optional cosmetic removal
    • These angiomas do not require treatment unless for cosmetic reasons. Removal options include laser therapy or electrocautery, but there is no medical necessity for intervention.
  4. (a) Aging
    • Cherry angiomas are age-related vascular changes and often appear after the age of 30. They are not linked to infections, sun damage, or nutritional deficiencies.