Verrucous Hemangioma and Angiokeratoma: Their Similarilities and Differences according to the Clinicopathological Features / 대한피부과학회지

ABSTRACT

BACKGROUND: Verrucous hemangioma (VH) and angiokeratoma (AK) are vascular birthmarks of an unclear nosology and these birthmarks commonly show a superficial hyperkeratotic vascular component. There are both similarilities and differences between VH and AK with some confusion concerning their overlapping features. OBJECTIVE: This study was undertaken to review the clinicopathological features of VHs and AKs and to determine the similarilities and differences between them. METHODS:We retrospectively reviewed 11 VHs and 7 AKs at the Vascular Anomaly Clinic of our hospital over the past 10 years. They were evaluated from the clinicopathologic point of view for factors such as the age of onset, location, size, symptoms, the histopathological epithelial change and involvement of deeper tissue. RESULTS: These birthmarks share common clinical features with the exception of gender and lesion size. Histopathologically, hyperkeratosis, acanthosis and capillary dilatation in the upper dermis were commonly seen. Yet lobular proliferation and dilatation of blood vessels in the deep dermis, or more importantly, the subcutis were detected in VH only. Furthermore there was a case of VH that showed diffusely scattered increased blood vessels in the subcutis, suggesting an evolving stage of VH and there was another case of VH that was erroneously diagnosed as AK via the initial biopsy, and the final diagnosis was changed according to the excised lesion. CONCLUSION:The two diseases share most of their clinicopathological features, but small parts of features like gender, the clinical size and the histological deep dermis/subcutis involvement were differences. Making the correct differential diagnosis between VH and AK through a deep biopsy with appropriate timing and long-term follow-up and/or radiological examination is helpful to avoid erroneous management.