Evaluation of telangiectasia and its risk factors in female employees in Tehran Shohada-ye Tajrish and Emam Hosein Hospitals during 1385-86
Introduction: telangiectasia is a dermal capillary lesion with 25% prevalence in women, mostly affects lower extremities. Common risk factors include positive family history, estrogen, trauma, obesity, longtime standing and associated coagulopathies. In epilation, as a common approach in hair cutting, skin pulled tightly with sticky substances. Thus, we evaluated telangiectasia relation with risk factors and epilation.
Methods and Materials: Required data of 178 female employees of Tehran Shohada-ye Tajrish and Emam Hosein Hospitals gathered via questionnaires to determine telangiectasia, its location, and association with risk factors.
Results: Statistical analysis with Chi- squire method confirmed relation of telangiectasia with family history (P.V=0.0001), varicose (P.V=0.0001), mumak( epilation sticky material)(P.V=0.0001), local steroid usage (P.V=0.005), aging (P.V=0.03), and longtime standing (P.V=0.02).
Discussion: Telangiectasia had 33% prevalence in our study, and it became clear women who used epilation at least one time had more prevalence than others and longtime standing is an environmental risk factor. Positive family history had the strongest relation with telangiectasia.
Suggestions: We can determine dermal telangiectasia association with some vascular disease as research projects and finding relation between epilation and telangiectasia needs large volume of cases and more randomized programs.
Telangiectasia means dilatation of terminal vessels which appear in skin or mucosa as little red lesions or linear or star shapes (1). Color of lesion varies from pink to strong red or strong blue and size 0.1 to 1 millimeter(2).
Telangiectasia can associate with systemic diseases such as SLE, dermatomyositis, sclorodermia, or Reynaud phenomenon (1). It is usually seen in old age, exposed skin against sun rays, following trauma or radiation. Smoking is another risk factor commonly associated male gender (3). Occasionally it is seen after radiation therapy in breast and brain tumors (4, 5).
Spider telangiectasia is prevalent as 15% and 2/3 pregnant women have at least one or two such lesions (6). Another kind of telangiectasia is around ankle associated with aging and is hidden under shoes (1). Other important risk factors include female gender, gene factors, hormonal, pregnancy, multiparity, obesity, and longtime standing (7, 8, 9, 10).
Cauterization, mostly used in the past to treat telangiectasia, is now excluded due to burning peripheral tissues (2). Nowadays , sclorotherapy is as gold standard of curing varicose veins or telangiectasia (2), which performs different materials such as hypertonic salin 20% (11), poly decanol 1%(12), glycerin chromate and foam 25% (13).
This study seeks prevalence of telangiectasia and its related risk factors in a small community like hospital female employees.
Methods and materials
All of cooperative female employees in Shohada-e- Tajrish and Emam Hosein hospitals included in the study. We need 170 cases (questionnaires) according to 20% prevalence in society .Then, interviewers completed questionnaires about information including OCP consumption, coagulopathies, estroid ointment use, smoking, history of DVT, varicose veins, manner of limb heir losing , positive family history, skin trauma history, skin color, time of standing using mumak ( sticky material performed for epilation).
178 women entered study with age average of 31.9 years old which distributed from 22 to 65 yrs. 62 patients of 69 affected with telangiectasia (95%), reported lower limb telangiectasia. Remaining 2.5% were in upper limb, and 2.5% in head and neck or trunk. 36 cases had telangiectasia and positive family history which means significant relation between telangiectasia and positive family history (P.V=0.0001) (chart.1)
Chart.1 comparison of telangiectasia between family history conditions
55 ones had lower limb varicose (30.9%) which 35 of them (52.2%) affected with telangiectasia with powerful statistical relation (P.V= 0.0001). 156 women (91%) stood 5 hours or more and only 16 women (9%) stood about 1 hour in a day. This result can be accepted due to this fact that most of cases were nurses. 56 of these 165 women, reported telangiectasia, that demonstrates meaningful relation between telangiectasia and longtime standing (P.V=0.02). (chart.2)
Chart.2 comparison of telangiectasia in group with 5 hours or more standing and group with only one hour standing
10 women (5.6%) were consuming OCP and only 6 cases had telangiectasia without significant meaningful relation (P.V=0.1)
Of 46 women who used mumak (epilation material) at least one time, 29 ones had telangiectasia which showed meaningful relation (P.V=0.0001). (chart.3)
Chart.3 comparison of telangiectasia in women according mumak use
Telangiectasia has 33% prevalence in our study that is more than other studies and references. Women involved telangiectasia had age average 33.7 yrs and non-affected ones ` was 30.8 yrs ( P.V=0.03).This confirms aging as a risk of telangiectasia that corresponds previous results.
Due to special job_ nursing- in our study which most of its attendants stand more than 5 hours in an on-day, varicose was common and we know both of them are risk factors of telangiectasia and our results noticed, too.
There was no previous result about mumak (epilation sticky material) and its relation with telangiectasia. We know trauma considered as a telangiectasia risk factor and applying mumak for epilation in our country seems entering trauma to skin. Our study showed women who used mumak at least one time had telangiectasia with more prevalence (P.V=0.0001). However, due to small size of cases we can`t generalized this result as independent risk factor( 9 of 23 women).
Longtime standing is an environmental risk factor for telangiectasia (P.V=0.02). 39 women used topical steroids, who 8 of them had telangiectasia (P.V=0.005), and old references accepted this relationship.
Positive family history had the most relation with telangiectasia in our study (P.V=0.0001), which is compatible with past researches on mutant genes. Of 10 OCP users, 6 had telangiectasia that had not significant relation (P.V=0.18), maybe due to little size of cases.
Because of powerful effect of family and inherited factors on telangiectasia, it can be a vascular disorder following genomic mutation that affects other vessels like brain capillaries. So, it is possible to search association between dermal telangiectasia and vascular diseases.
Moreover, it`s recommended to choose more randomized cases with bigger sizes to find relation between mumak and telangiectasia with meaningful statistics.
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