Hobnail Hemangioma Low-magnification view of a hobnail hemangioma (HH) demonstrates superficial dilated vascular spaces in the papillary dermis with deeper small blood vessels and stromal hemosiderin deposits .
Higher Magnification of Superficial HH Higher power examination of the superficial portion of an HH shows superficial dilated vessels lined by small endothelial cells with nuclear hyperchromasia protruding into the lumina .
Deeper Vessels and Hemosiderin Deposits in HH Histologic examination of the deeper aspect of the lesion shows small, thin-walled blood vessels and prominent hemosiderin deposition in the stroma .
More Cellular Example of HH This is an example of a more cellular HH composed of many closely apposed vessels in the superficial dermis, many of which show very small, compressed lumens . Hobnailed endothelial cells can be appreciated in some of the vessels .
Hobnail hemangioma (HH)
Targetoid hemosiderotic hemangioma (clinical term)
Benign vascular proliferation, typically wedge-shaped, showing intravascular papillae and hobnailed endothelial cells
Trauma has been implicated in some cases
Postulated to represent traumatized lymphangioma or hemangioma
Young to middle-aged adults
More common in males
Typically present on lower extremities; also may occur on upper extremities, rarely in oral cavity
Skin papule or nodule
Often pigmented due to hemosiderin deposition
May show halo (targetoid appearance) in minority of cases
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