A Clinical and Histopathologic Study of Angiokeratoma

Cho, Dae Young; Won, Young Ho; Chun, Inn Ki

Abstract

BACKGROUND: Angiokeratoina is a vascular dermatosis characterized by telangiectasia or hemangioma with a horny overgrowth. Five clinical types have been reported as follows ; angiokeratoma corporis diffusum of Fabry, angiokeratoma of Mibelli, angiokeratoma of Fordyce(AF), papular angiokeratoma(PA) and angiokeratoma circumscriptum (AC). There has not been any report on the general status of angiokeratoma in Korea except several case reports.
OBJECTIVE
The purpose of this study was to review the clinical and histopathological feature of 23 cases diagnosed as angiokeratoma.
METHODS
We reviewed cetrospectively twenty-three cases with angiokeratoma who were patients at the Department of Dermatology, Chonnam University during the past 15 years from 1981 to 1995. The clinical and histopathological features of the patients were evaluated and classified into five clinical types by Lever and Schaumburg-Lever's classification.
RESULTS
Total number of patients with angiokeratoma were 23 and consisted of 11 of PA(48%), 9 of AC (39%), 3 of AF(13%). The ratio of males to females was 1.3: 1. The mean age was 23.1 years. The first onset was predominantly from the first to second decades of life in 65.2%. The most predilection site in the patients was lower extremities(74%), followed by genitalia(13.0 %), trunk(8.7%), and neck (4.3%). All lesion of the AC appeared on the lower extremities. The lesions were usually asymptomatic(47.8%), however, pruritus and pain were complained of in 34. 8% and 17.4% cases respectively. The size of the lesions was below 1cm in 34.8%, 1-2cm in 30.4%, and more than 2cm in 34.8%. Each clinical type of angiokeratoma was essentially similar in its histopathologic findings. The most prominent, epidermal change was rete ridge elongation in 100%, followed by acanthosis in 78.3%, and hyperkeratosis in 73.9%. The dilated capillary in the upper dermis was encircled partially by elongated rete ridges in PA and AF. Dilated vessels and hemangiomatous vascular changes were found in the mid and low dermis in 8 cases of AC, and in the subcutis in 3 cases of AC.
CONCLUSION
Angiokeratomas are benign vascular tumors which occurs commonly on the leg of young adults. Three types of the angiokeratomas, namely PA(11cases, 48%), AC(9cases, 39% ), and AF(3cases, 13%), were observed.