Home » Skin Conditions & Disorders » Cherry angiomas » Sudden Appearance of Multiple Cherry Angiomas (Eruptive)

Sudden Appearance of Multiple Cherry Angiomas (Eruptive)

by

The sudden appearance of many cherry angiomas is termed “eruptive cherry angiomas.” There isn’t much data or research to help us identify its causes. However, there are a few case reports and observational studies which show its association with certain factors.

In this article, we will review factors associated with eruptive cherry angiomas and when you should worry about them.

Multiple cherry angiomas.

Cherry angiomas, also called Campbell de Morgan spots or red moles, are common skin growths that consist of small blood vessels called capillaries. These appear as red or purple spots on the skin.

They are very common and most people start seeing them after the age of 30 years. What causes cherry angiomas is still not completely clear, although many factors are associated with it.

What are eruptive cherry angiomas?

The sudden appearance of multiple cherry angiomas is called eruptive cherry angiomas. This term is not well-defined so when we say multiple cherry angiomas, we do not have a specific cut-off number.

Causes

The exact reason why eruptive cherry angiomas appear is not clearly understood. There are few associated factors, however, the data is scarce with very few case reports. These factors may be merely coincidental and should not be considered as direct causes. 

More data and studies are needed to fully understand why eruptive cherry angiomas develop. 

A lot of individuals get exposed to the factors mentioned below, but only a handful of patients develop eruptive cherry angiomas. 

In most cases, the exact reason behind the sudden appearance of cherry angiomas may not be identifiable.

1. Pregnancy 

Some women may experience the sudden appearance of cherry angiomas during pregnancy. This may be due to hormonal changes, especially prolactin. 

2. Use of topical nitrogen mustard

The use of topical nitrogen mustard therapy may lead to cherry angiomas. There is a case report where topical nitrogen mustard was used for treatment of vitiligo and multiple cherry angiomas appeared at or around the re-pigmented vitiligo spots. Once the treatment was stopped, new cherry angiomas stopped appearing.

3. Side effect of cyclosporine

Another case report describes a patient with psoriasis, who developed eruptive cherry angiomas after treatment with cyclosporine.

4. Lymphoproliferative diseases like multicentric Castleman disease (MCD)

There is some data where eruptive cherry hemangiomas are associated with lymphoproliferative diseases (these are a group of diseases in which there is uncontrolled production of white blood cells called lymphocytes).

There is a case report where a 25-year-old male with multicentric Castleman disease developed multiple cherry angiomas along with systemic symptoms (like lymphadenopathy, weight loss, fatigue, night sweats, and fever).

It is thought that it may be due to hypersecretion of vascular endothelial growth factor. 

5. Exposure to 2-butoxyethanol

There is some data that four months after exposure to vaporized 2-butoxyethanol, six individuals started getting cherry angiomas on the arms, trunk, and thighs.

6. Bromides

Derivatives of bromine are also associated with eruptive cherry angiomas. Two laboratory technicians developed multiple cherry angiomas on the trunk and extremities after prolonged exposure to brominated compounds.

7. Due to Ramucirumab

There is one case report where a patient with gastric adenocarcinoma developed multiple cherry angiomas after treatment with ramucirumab (medication used to treat certain cancers). In this patient, immunosuppression may also play a role. 

8. Human herpesvirus-8 (HHV8) infection

One study found that 53% of eruptive CAs were positive for Human herpesvirus-8.

9. Graft vs host disease

Eruptive angiomas are also associated with graft versus host disease (this is a complication that occurs when transplanted cells attack the recipient’s healthy cells).  

10. Immunosuppression

Chronic immunosuppression is strongly associated with eruptive cherry angiomas as per one observational study.

11. COVID-19 vaccination

There is one case report where a 55-year-old female developed eruptive cherry angiomas after the first dose of COVID-19 vaccination and subsequently after the second dose. 

When to see a doctor

Cherry angiomas are very common and many individuals may get them with age. Cherry angiomas themselves are harmless and do not become cancerous.

However, if you develop many cherry angiomas in a short time like days, weeks, or a few months, without any known reason like hormonal changes or pregnancy, it is best to see a doctor.

In addition, you should see a doctor if:

  • You get multiple cherry angiomas along with systemic symptoms like enlarged lymph nodes, fever, fatigue, or weight loss.
  • The cherry angiomas change in appearance like shape, size, or texture.
  • If your child has multiple red moles (make sure they are not something else).
  • If you’re not sure that the red bumps on your skin are cherry angiomas, you should see a doctor to make sure they are not cancerous.
  • If you want to remove cherry angiomas.

Sometimes, spider angiomas can be mistaken for cherry angiomas. Spider angiomas are associated with chronic liver disease.

Cherry angiomas appear as round or oval circumscribed red bumps whereas spider angiomas have a central red body with red extensions (like a spider).

Key points

Cherry angiomas are harmless skin lesions and usually one does not need to be concerned about them.

If you see a sudden appearance of multiple cherry angiomas on your skin without any known reason, it’s best to see a doctor and get them examined to make sure they are not something else or related to any other medical condition.

References

Disclaimer: This blog post is for information purposes only and does not replace medical advice.

Share this article