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Angiokeratoma pathology

Author: Adjunct A/Prof Patrick Emanuel, Dermatopathologist, Clínica Ricardo Palma, Lima, Peru. DermNet NZ Editor in Chief: Adjunct A/Prof Amanda Oakley. October 2018. 


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Introduction

Angiokeratoma presents as a blood-filled papule which may bleed following trauma. There are a range of clinical presentations ranging from isolated lesions of little consequence to widespread lesions associated with Fabry disease. 

Histology of angiokeratoma

In angiokeratoma, the histopathology shows a vascular lesion in the superficial dermis which extends into the epidermis. There is epidermal hyperplasia and papillomatosis. There may be intravascular thrombosis (figures 1,2).

Angiokeratoma pathology

Special studies for angiokeratoma

None are generally needed.

Differential diagnosis for angiokeratoma

Other diagnoses to be considered include:

  • Melanoma — this can be a clinical consideration, particularly when intravascular thrombosis causes the lesion to darken
  • Verrucous haemangioma — this will also involve the deep dermis and subcutis (not a feature of angiokeratoma).

 

 

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