Angiokeratoma: causes, symptoms, diagnosis, treatment

Angiokeratoma occurs due to epithelial bulging and the formation of subepidermal expansions of capillary cavities, which is accompanied by reactive changes in the epidermis.

The group of angiokeratomas includes: angiokeratoma of Mibelli, diffuse angiokeratoma of the body of Fabry, angiokeratoma of the body of limited neviform.

Angiokeratoma of Fordyce (synonym: angiokeratoma of the scrotum)

Causes and pathogenesis. The presence of arteriovenous anastomoses and injuries (for example, scratching) are important in the development of the disease. Middle-aged people, more often men, are affected.

Symptoms. The presence of multiple papules on the skin of the scrotum and labia majora is noted. The papules are dark red or dark purple, 1 to 4 mm in size, hemorrhagic with hyperkeratotic layers in the center, bleeding is noted when removed.

Histopathology: Lacunae and dilated venules are observed in the suprapapillary dermis.

Treatment. In many cases, treatment is not performed. In case of bleeding angiokeratomas, electro-, laser-, and cryodestruction are used.

Angiokeratoma corporis circumscribed neviformis (synonym: angiokeratotic nevus)

The disease was described by Fabry in 1915.

The causes and pathogenesis of the disease have not been fully established. Many scientists attribute this disease to developmental defects that form in the embryonic period. Angiokeratoma corporis limited neviformis is not associated with enzymatic disorders and differs from diffuse angiokeratoma corporis Fabry. The disease is rare.

Symptoms of angiokeratoma. The disease usually manifests itself at birth, but sometimes it can appear in childhood or even in adulthood. There are also reports of the appearance of neviform angiokeratoma in puberty. It can exist independently or be part of a syndrome, for example, Klippel-Trenaunay-Weber syndrome, Sturge-Weber-Krabbe syndrome. It can be combined with cavernous hemangioma, be a private manifestation of systemic malformations of the vascular system. The rash is localized on the lower, less often - on the upper limbs, even less often have the form of livid-red, dark-red soft nodules 1-2 mm in diameter that do not disappear when pressed. The rash is unevenly distributed on limited or large areas of the skin, sometimes segmentally. There are limited and widespread forms of the disease. Hyperkeratosis on the surface of the nodules is expressed very unevenly, is often clinically unnoticeable and can only be detected by histological examination. Various variants of the clinical picture of the disease are observed.

Histopathology. In the papillary layer of the dermis, cavernous dilated vascular cavities with a capillary structure of the walls lined with unchanged endothelium are noted, above them - a very thin layer of collagen tissue. The epidermis is thinned and hyperkeratotic.

Differential diagnosis should be made with true angiomas, diffuse Fabry angiokeratoma.

Treatment of angiokeratoma. Surgical excision of nodules or their removal with liquid nitrogen is performed.

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