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).
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).