Usually on extremities
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Angiokeratoma of Fordyce
Elderly men
Multiple lesions, often on scrotum
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Angiokeratoma of Mibelli
Childhood
Warty lesions over bony prominences of acral locations
•
Angiokeratoma corporis diffusum
Associated with Anderson-Fabry disease
•
Angiokeratoma circumscriptum
Presents in children
Least common subtype
Microscopic
•
Marked ectasia of papillary dermal blood vessels
•
Vessels herniate into epidermis, resulting in appearance of intraepidermal vessels
•
Hemorrhage in stratum corneum common
•
May have evidence of thrombosis and intravascular papillary endothelial hyperplasia
•
Reactive epidermal changes: Acanthosis, hyperkeratosis, and elongation of rete ridges around ectatic vessels
Top Differential Diagnoses
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Verrucous hemangioma
Verrucous epidermal hyperplasia
Superficial and deep vascular proliferation
•
Pyogenic granuloma (lobular capillary hemangioma)
Polypoid lesion with epidermal collarette
Granulation tissue-like dermal vascular proliferation
TERMINOLOGY
Definitions
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Ectatic superficial dermal blood vessels associated with reactive epidermal hyperplasia
CLINICAL ISSUES
Presentation