Spider neavi is a feature of
**Core Concept**
Spider neavi, also known as spider angioma, are small, dilated blood vessels near the surface of the skin that resemble a spider's web. They are characterized by a central red spot representing the arteriole, with radiating dilated venules giving a characteristic spider-like appearance.
**Why the Correct Answer is Right**
Spider neavi are often associated with liver disease, particularly liver cirrhosis, due to the shunting of blood from the liver to the skin, leading to the formation of these characteristic lesions. This is because the liver's inability to detoxify and metabolize substances leads to an increase in circulating estrogen, which causes vasodilation and the formation of spider neavi. Additionally, the increased pressure in the hepatic veins leads to portal hypertension, which also contributes to the development of spider neavi.
**Why Each Wrong Option is Incorrect**
**Option A:** While liver disease is a common association with spider neavi, it is not the only condition that can cause these lesions. Other conditions such as pregnancy, anemia, and malnutrition can also lead to the formation of spider neavi.
**Option B:** While estrogen is a key factor in the development of spider neavi, it is not the only hormone involved. Other hormones such as progesterone and testosterone can also contribute to the formation of these lesions.
**Option C:** While portal hypertension is a contributing factor to the development of spider neavi, it is not the sole cause. The exact mechanism of how spider neavi form is still not fully understood and is likely to be a complex interplay of multiple factors.
**Clinical Pearl / High-Yield Fact**
Spider neavi are often a sign of underlying liver disease, particularly cirrhosis, and should prompt further investigation to rule out liver disease.
**Correct Answer: C** Liver disease