title: Are the spider angiomas skin markers of hepatopulmonary syndrome?
abstract: BACKGROUND
  Hepatopathies can significantly influence both veins and arteries, these changes may cause some cutaneous stigmas, such as spider angioma (SA) and some systemic vascular changes, such as those observed in hepatopulmonary syndrome (HPS). Based on this common pathophysiological root we can assume that the SA can be skin markers of HPS.
  
  
  OBJECTIVE
  The objective of this study is to assess whether there is a relationship between the presence of SA and HPS.
  
  
  METHODS
  Records of 40 patients with liver cirrhosis who underwent contrast echocardiography were evaluated, in which we researched the description of SA, physical examination, and other clinical and laboratory data. For diagnosis of HPS we use these signs of the disease: presence of liver disease (cirrhosis in the case), abnormalities in gas exchange by arterial blood gases, and evidence of pulmonary vasodilations by the contrast echocardiography.
  
  
  RESULTS
  The SA were found in 21/40 (52.5%) patients and hepatopulmonary syndrome in 9/40 (22.5%). The HPS was observed in 8/21 (38.1%) of patients with SA and 1/19 (5.3%) patients were without this sign (P<0.01). We found no statistically significant difference between the SA and the presence of HPS with sex or age. Patients with SA had a higher hypoxemia [PaO2 84.8 ± 11.5 mmHg and 19.8 ± 14.7 mmHg alveolar-arterial gradient of oxygen (AAG)] than those without SA (PaO2 90.8 ± 10.7 mmHg and 10.9 ± 11.7 AAG mmHg) (P<0.05).
  
  
  CONCLUSIONS
  Our findings show a correlation between the presence of SA and HPS, suggesting that the SA may be cutaneous markers of HPS.
authors: Pontifícia Universidade Católica de Goiás, Departamento de Medicina.
authors: Américo de Oliveira
authors: Ade O
authors: Silvério
authors: Dayanne Cintra
authors: DC
authors: Guimarães
authors: Larissa Fernanda Queiroz
authors: LF
authors: Elias
authors: Erika Oliveira
authors: EO
authors: Milanez
authors: Silvano
authors: S
authors: Naves
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006391:Hemangioma / Q000209:etiology*; D020065:Hepatopulmonary Syndrome / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000209:etiology*; D055815:Young Adult