Verrucous Hemangioma
Steven D. Billings, MD
David Cassarino, MD, PhD
Key Facts
Clinical Issues
Presents in children
Dark blue nodule
Surface has warty appearance
Most common on the extremities
Microscopic Pathology
Epidermis is acanthotic and papillomatous
Cavernous vascular spaces
Dilated capillaries
Vascular proliferation involves superficial and deep dermis
Top Differential Diagnoses
Angiokeratoma
In angiokeratoma, vascular proliferation restricted to superficial dermis
Lymphangioma
Hamartomatous vascular lesions
Pyogenic granuloma (lobular capillary hemangioma)
 Verrucous hemangioma has an acanthotic papillomatous epidermis  and ectatic dermal blood vessels  involving both the superficial and deep dermis. |
 In addition to the verrucous-like epidermal changes, this case demonstrates cavernous vascular spaces  in close apposition to the epidermis, resembling an angiokeratoma. |
TERMINOLOGY
Definitions
Vascular tumor with superficial verrucous appearance
ETIOLOGY/PATHOGENESIS
Developmental Anomaly
Most likely a congenital lymphovascular malformation
CLINICAL ISSUES
Epidemiology
Incidence
Very rare lesion
Age
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