Papule on thigh

The physician performed a 2-mm punch biopsy, which revealed that the lesion was an angiokeratoma. An angiokeratoma is a benign pink-red to blue-black variably sized papule or plaque that is typically 2 to 10 mm in diameter. Angiokeratomas are composed of a series of subepidermal dilated capillaries that have a characteristic hyperkeratotic surface and bleed easily. These lesions are rare, with a prevalence estimated to be 0.16% in the general population.

The pathogenesis of angiokeratoma formation in unclear; however, there are multiple theories. The development of these lesions may be related to repeated trauma or friction at a particular site. Alternatively, increased venous blood pressure or primary degeneration of vascular elastic tissue could explain their development. While their cause is unclear, the initial event in the development of an angiokeratoma is believed to be the development of a vascular ectasia within the papillary dermis. The epidermal reaction appears to be a secondary phenomenon due to increased proliferative capacity on the surface of the vessels.

If the diagnosis is straightforward and biopsy is not needed, no treatment is needed because simple angiokeratomas are benign entities. However, treatment may be considered for cosmetic purposes, or to prevent bothersome bleeding.

In the case of this patient, the lesion was removed by shave biopsy with clear margins.

Adapted from:

Clark SM, Beachkofsky TM, Wisco OJ, et al. Photo Rounds: Verrucous papule on thigh. J Fam Pract. 2010;59:645-648.

The physician performed a 2-mm punch biopsy, which revealed that the lesion was an angiokeratoma. An angiokeratoma is a benign pink-red to blue-black variably sized papule or plaque that is typically 2 to 10 mm in diameter. Angiokeratomas are composed of a series of subepidermal dilated capillaries that have a characteristic hyperkeratotic surface and bleed easily. These lesions are rare, with a prevalence estimated to be 0.16% in the general population.

The pathogenesis of angiokeratoma formation in unclear; however, there are multiple theories. The development of these lesions may be related to repeated trauma or friction at a particular site. Alternatively, increased venous blood pressure or primary degeneration of vascular elastic tissue could explain their development. While their cause is unclear, the initial event in the development of an angiokeratoma is believed to be the development of a vascular ectasia within the papillary dermis. The epidermal reaction appears to be a secondary phenomenon due to increased proliferative capacity on the surface of the vessels.

If the diagnosis is straightforward and biopsy is not needed, no treatment is needed because simple angiokeratomas are benign entities. However, treatment may be considered for cosmetic purposes, or to prevent bothersome bleeding.

In the case of this patient, the lesion was removed by shave biopsy with clear margins.

Adapted from:

Clark SM, Beachkofsky TM, Wisco OJ, et al. Photo Rounds: Verrucous papule on thigh. J Fam Pract. 2010;59:645-648.

The physician performed a 2-mm punch biopsy, which revealed that the lesion was an angiokeratoma. An angiokeratoma is a benign pink-red to blue-black variably sized papule or plaque that is typically 2 to 10 mm in diameter. Angiokeratomas are composed of a series of subepidermal dilated capillaries that have a characteristic hyperkeratotic surface and bleed easily. These lesions are rare, with a prevalence estimated to be 0.16% in the general population.

The pathogenesis of angiokeratoma formation in unclear; however, there are multiple theories. The development of these lesions may be related to repeated trauma or friction at a particular site. Alternatively, increased venous blood pressure or primary degeneration of vascular elastic tissue could explain their development. While their cause is unclear, the initial event in the development of an angiokeratoma is believed to be the development of a vascular ectasia within the papillary dermis. The epidermal reaction appears to be a secondary phenomenon due to increased proliferative capacity on the surface of the vessels.

If the diagnosis is straightforward and biopsy is not needed, no treatment is needed because simple angiokeratomas are benign entities. However, treatment may be considered for cosmetic purposes, or to prevent bothersome bleeding.

In the case of this patient, the lesion was removed by shave biopsy with clear margins.

Adapted from:

Clark SM, Beachkofsky TM, Wisco OJ, et al. Photo Rounds: Verrucous papule on thigh. J Fam Pract. 2010;59:645-648.