Dermatology: Practical and Conceptual Research Letter | Dermatol Pract Concept. 2025;15(3):5501 1 Abdominal Telangiectasia in Newborns: A Comprehensive Retrospective Review of Clinical Cases Tullio Brunetti1,2, Marco Adriano Chessa1,2, Francesco Paolo Salamone1,2, Alessandra Gelmetti1,2, Iria Neri1 1 Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy 2 Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy Key words: Transient Abdominal Telangiectasia, Telangiectasia, Vascular malformations, Newborn, Self-limiting Condition Citation: Brunetti T, Chessa MA, Salamone FP, Salamone FP, Gelmetti A, Neri I. Abdominal Telangiectasia in Newborns: A Comprehensive Retrospective Review of Clinical Cases. Dermatol Pract Concept. 2025;15(3):5501. DOI: https://doi.org/10.5826/dpc.1503a5501 Accepted: March 28, 2025; Published: July 2025 Copyright: ©2025 Brunetti et al. This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited. Funding: None. Competing Interests: None. Authorship: All authors have contributed significantly to this publication. Corresponding Author: Marco Adriano Chessa MD, PhD, Via Massarenti 1, 40138 Bologna Italy. Orcid ID: 0000-0002-0149-8870. E-mail: marcoadriano.chessa@gmail.com Introduction TATN is a benign, self-limiting condition characterized by symmetric deep red telangiectatic patches on the abdomen, typically in the periumbilical region [1-3]. Case Presentation A retrospective case series was conducted in 2023 at the Pediatric Dermatology Clinic of Sant’Orsola Malpighi Uni- versity Hospital. Written parental consent for the scientific use of images was obtained, and the study adhered to the Declaration of Helsinki. Five term newborns with uncomplicated pregnancies and deliveries were identified with transient abdominal tel- angiectasia of the newborn (TATN). Two were males and 3  were females, with a median diagnosis age of 16 days (range:  8–30  days). Physical examination showed radial purplish telangiectasia in a “butterfly wing” pattern on the abdomen (Figure 1A–C). Dermoscopy, at ×10 magnification, revealed bright red, irregularly branched vessels against an unstructured background (Figure 1D). None of the patients had a family history of complicated trauma or delivery, and abdominal ultrasonography revealed no abnormality. Associated findings included high-flow vas- cular malformation (HI-MAG) in patient 1, telangiectatic cutis marmorata in patient 2, elongated APTT in patient 3, capillary malformation in patient 4, and no clinical finding in patient 5. The condition resolved spontaneously in all cases, with an average resolution time of 40.8 days (Table 1). In our series, telangiectasias resolved spontaneously within an average of 40.8 days, confirming TATN’s benign nature, with associated findings like vascular malforma- tions or elongated APTT likely being coincidental. Although 2 Research Letter | Dermatol Pract Concept. 2025;15(3):5501 Table 1. Patient Characteristics and Associated Findings. Patient number Age in days at diagnosis Sex Location Time of resolution from the diagnosis Other associated findings Ecographic findings 1 12 days M Abdominal in the periumbilical region. 47 days IHMAG No clinical findings 2 12 days F Abdominal in the periumbilical region. 33 days Cutis marmorata No clinical findings 3 18 days M Abdominal in the periumbilical region. 31 days APTT elongated No Clinical findings 4 8 days F Abdominal in the periumbilical region. 44 days Capillary malformation No clinical findings 5 30 days F Abdominal in the periumbilical region. 49 days No clinical findings No clinical findings Figure 1. (A-C) Patches of purplish telangiectasia on the abdomen in the periumbilical region (black arrow). (D) Dermoscopy, at ×10 magnification, revealed bright red, irreg- ularly branched vessels against an unstructured background. abdominal ultrasonography revealed no abnormality in our cases, careful clinical evaluation is essential to rule out un- derlying conditions. Juzot et al. reported TATN in association with Hirschsprung disease and rhabdomyosarcoma, highlighting the need for vigilance. However, no intra-abdominal or pel- vic mass was identified in our cohort, reinforcing that TATN is not linked to significant abnormalities [1]. We hypothesize that transient increases in intra-abdominal pressure, as suggested in the literature, could contribute to the development of TATN [1-3]. Abdominal distension in newborns typically arises from non-pathological factors, such as air swallowed during feeding or crying due to im- mature intestinal motor control, gas from the developing microbiota adapting to breast milk or formula, and meco- nium accumulation in the first days of life. These transient Research Letter | Dermatol Pract Concept. 2025;15(3):5501 3 conditions can raise intra-abdominal pressure, impairing local venous return and causing telangiectasias through con- gestion of superficial cutaneous vessels. The periumbilical area is particularly prone to this phenomenon due to its rich vascular network and connection to the portal venous sys- tem via paraumbilical veins. Conclusion TATN is a benign condition, and our findings confirm its transient nature and the absence of significant pathology, as abdominal ultrasonography consistently showed normal results [1-3]. While vascular malformations were noted in some cases, they do not appear directly related to TATN. Re- ports by Juzot et al. of TATN in patients with Hirschsprung disease and rhabdomyosarcoma underscore the importance of clinical vigilance and thorough evaluation [1]. However, in our series, TATN was confirmed as a dis- tinct, benign phenomenon. TATN may be underdiagnosed due to its asymptomatic, self-limiting nature, and larger cohort studies are needed to better understand its pathophysiology, confirm its benign na- ture, and explore any subtle associations. References 1. Juzot C, Aubert H, Bessis D, Boccara O, Bourrat E, Chiaverini C, et al. Transient abdominal telangiectasia of the newborn. Pediatr Dermatol. luglio 2021;38(4):864–7. 2. Bosma AL, Van der Zwaan D. [Abdominal telangiectasias in a newborn]. Ned Tijdschr Geneeskd. 5 ottobre 2022;166: D6960. 3. Cutrone M, Van Gysel D. Transient abdominal telangiectasia of the newborn: Four new cases with abdominal distension. Pediatr Dermatol. 2024;41(1):73–5.