O Spider Naevi

We were having bedside teaching session with the most respectful , awesome Mr. J (HOD Medicine) last week.

I was standing right behind him during the session. He kept asking us about little things like, what is the causes of flapping tremors, which I was pointed 2 seconds after he finished his sentence, and luckily I managed to answer the question accurately: Carbon dioxide retention.

Fine. Score for me. Yeay!

The he went again with his little questions like, causes of clubbing, pitting edema, pallor of the conjunctiva, icteration of the sclera, and suddenly, he was asking about spider naevi (because we were examining a man with a this liver symptoms, yes, u know the drill).

Right after he finished his sentence, everyone tried to answer the question, but somehow, there were too many theories. Some said more than 5, more than 3, and I loudly said, more than 4, which is a bit different from other people's answer. (Seriously man, i read that somewhere!)

Then he spotted my chipmunk-like voice and pointed his long finger at me, again! And he goes like this: You! (well, the exclamation mark used here didnt mean he was shouting at me ok). Find out for us how many spider naevi are clinically important, and tell us about its pathophysiology too.

Oh God, why, why, off all people, you chose me for this task. I got a lot of stuffs already going on in my list.

Ok, back to the point.

Dear people, can you guys help me out with the question? I need a concrete answer on HOW MANY SPIDER NAEVI ARE CLINICALLY IMPORTANT? I got the bloody pathophysiology already. And I would really appreciate it people, if you can give me any journal/ textbook that would support your answer.

TQ in advance. =)