Cherry angiomas and petechiae are common skin lesions that can appear as small red dots. Cherry angiomas are harmless and do not require treatment while petechiae can occur due to a variety of reasons which may require treatment.
This article reviews the differences between cherry angioma and petechiae, their causes, and treatment.
What are they?
Cherry angiomas (also called red moles) are non-cancerous skin growths that consist of small blood vessels called capillaries. These are located just under the top layer of the skin (epidermis). These are commonly seen in adults over the age of 30 years.
Petechiae are red or purple spots on the skin which appear due to bleeding into the skin. These are also referred to as blood spots. They can be seen at any age, although they are often seen in the elderly and children.
Difference in appearance
What does cherry angioma look like?
Cherry angiomas usually appear as bright red spots on the skin. Sometimes, they may appear dark red, purple, or bluish in color.
They may be flat lesions, especially the early spots but very often you will see them as – well-circumscribed, round to oval bumps.
They can occur anywhere on the skin, although most commonly they are seen on the chest, abdomen, back, and arms.
What do petechiae look like?
Petechiae usually appears as red, reddish brown, or purple spots on the skin. They can appear as a single spot or in a cluster (may look like a rash).
Petechiae are usually flat so if you touch them, you won’t feel them. In addition, they are not-blanch-able – they won’t fade if pressure is applied to them. They can appear both on the skin and the mucosal surfaces.
Other symptoms
Cherry angiomas are usually asymptomatic and do not itch or hurt. However, if the angiomas are traumatized, they can bleed.
Petechiae do not itch, but one may have other symptoms associated with the underlying medical condition. For example, petechiae due to an infectious cause may be accompanied by symptoms like fever, fatigue, enlarged lymph nodes, sore throat, etc.
Causes
Cherry angiomas
The exact cause of cherry angiomas is not known. However, they are associated with several factors: aging, genetics, hormonal changes like in pregnancy, exposure to certain chemicals and medications, immunosuppression, diabetes, and tropical climate.
Petechiae
Petechiae, itself, is not a condition, but rather a sign of other medical conditions. The underlying cause can be harmless like straining from vomiting or minor injury or it can be serious like cancer or widespread infection.
The causes of petechiae include:
- Thrombocytopenia (decrease in platelet count which is a type of blood cells required for blood clotting)
- Infections like meningococcemia, infectious mononucleosis, infective endocarditis, and viral hemorrhagic fevers like Ebola or dengue.
- Drugs like antibiotics, anti-seizure medications, NSAIDs, or certain heart medications.
- Straining due to coughing, vomiting, or giving birth.
- Autoimmune conditions like lupus.
- Leukemia/blood cancer.
- Vitamin C or K deficiency.
Diagnosis
Cherry angiomas are usually diagnosed by a doctor after a physical examination of the skin lesions. If the red mole looks suspicious, they may choose to do additional testing like a biopsy or they may cut the red mole out and send it to the lab to confirm the diagnosis.
Petechiae can occur due to various reasons so your doctor may perform a physical examination and do some diagnostic tests to find the cause. If needed, this may be followed by additional testing to pinpoint the diagnosis.
Treatment
Cherry angioma
Cherry angiomas do not require treatment. However, if the person does not like their appearance or frequently gets traumatized and bleeds, cherry angiomas can be removed in a doctor’s office via the following procedures:
- Lasers: These use a concentrated beam of light to target the blood vessels.
- Cryotherapy: It freezes the angiomas.
- Electrodesiccation: It uses electric current to target the angioma.
- Excision: Cherry angioma is either shaved or cut out from the skin.
Treating cherry angiomas does not prevent them from coming back. So, one may still see new spots with age.
Petechiae
Petechiae due to straining or minor injury usually go away on their own. However, petechiae that appear due to underlying medical conditions will need treatment.
The treatment will depend on the medical condition.
- If these were caused by drugs, your doctor may modify the dose or prescribe another medication.
- For infections, antibiotics or antiviral medications may be prescribed.
- For autoimmune disorders, steroids or immunosuppressants may be prescribed.
- Blood cancer/leukemia may require chemotherapy, radiation therapy, or bone marrow transplant.
- Petechiae due to vitamin deficiencies will require supplementation or dietary modifications.
Read the full article on cherry angioma and petechiae.
When to see a doctor
Cherry angiomas and petechiae can look similar. If you are not sure that the red spots on your skin are cherry angioma or petechiae, it’s best to see a doctor for evaluation.
Cherry angiomas are not dangerous but petechiae can be caused by serious medical conditions which may require immediate medical care.
You should also see a doctor if the red spots on your skin change in appearance or are accompanied by:
- Fever or fatigue.
- Enlarged lymph nodes
- Bleeding from mouth or blood in urine and stool.
- Dizziness or confusion.
Note: Any child with fever and petechiae requires immediate medical attention.
Key points
Cherry angiomas and petechiae can appear as pinprick red spots on the skin. Petechiae usually appear as flat red dots on the skin while cherry angiomas can present both as flat red spots or raised red bumps.
Cherry angiomas are often seen in adults over the age of 30 years and their incidence increases with age. Petechiae are often seen in children and the elderly.
Cherry angiomas usually appear on the trunk and arms while you can see petechiae appear anywhere on the body – both on skin and mucous membranes (which may be influenced by the underlying cause).
Cherry angiomas are harmless and do not require treatment while depending on the cause, petechiae may require treatment.
Cherry angiomas do not go away on their own so one will need a procedure like laser or excision which is done in a doctor’s office. Petechiae, on the other hand, may resolve once the underlying cause is treated.
If you’re not sure whether you have a cherry angioma or petechiae, it’s best to see your doctor.
Read more:
References
- McGrath A, Barrett MJ. Petechiae. 2022 Sep 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 29493956.
- Qadeer HA, Singal A, Patel BC. Cherry Hemangioma. [Updated 2022 Oct 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
- Buslach N, Foulad DP, Saedi N, Mesinkovska NA. Treatment Modalities for Cherry Angiomas: A Systematic Review. Dermatol Surg. 2020 Dec;46(12):1691-1697. doi: 10.1097/DSS.0000000000002791. PMID: 33252464.
Disclaimer: This blog post is for information purposes only and does not replace medical advice.