Original article
Poikilodermatous plaque-like hemangioma: Case series of a newly defined entity

https://doi.org/10.1016/j.jaad.2019.03.069Get rights and content

Background

We present a distinctive type of acquired vascular proliferation, for which we propose the name of poikilodermatous plaque-like hemangioma.

Objective

The aim of this study was to summarize the clinical and histopathologic features in a case series of poikilodermatous plaque-like hemangioma.

Methods

Sixteen cases were identified from the routine clinical and referral practices of the authors. Clinical characteristics, including demographic details and clinical morphology, were collated. The salient histopathologic features, including immunohistochemical staining results, were summarized.

Results

The lesions were usually solitary erythematous-to-violaceous poikilodermatous plaques on the lower extremities and pelvic girdle, with an indolent clinical course. Mean age of affected patients was 72 (range 58-80) years, and there was a male predominance. Histology comprised a distinctive band-like proliferation of vascular channels suggestive of postcapillary venules within the superficial dermis with a background of fibrosis, edema, and loss of elastic fibers. Despite the clinical atrophic appearance, acanthosis was a frequent finding.

Limitations

Retrospective study.

Conclusion

Poikilodermatous plaque-like hemangioma is a distinctive and previously undescribed vascular proliferation defined by a constellation of consistent and reproducible clinical and histologic features.

Section snippets

Materials and methods

A total of 16 cases were identified. Most of the cases (n = 13) were retrieved from the consultation files of 1 of the authors (Dr Calonje) or were sent to the St. John's Institute Department of Dermatopathology for second opinion. Additional cases were retrieved from the consultation files of 2 of the other authors (Dr Carr and Dr Taibjee). The clinical picture was similar in all cases. Patients presented with a solitary atrophic erythematous or violaceous plaque or, in rare cases, slightly

Clinical features

Patient age ranged from 58 to 80 (mean 72) years. The lesion duration, available for 13 patients, ranged from 2 months to 6 years (mean 2.5 years). There was a male predominance (male-to-female ratio 14:2). Lesions were typically described as slowly growing, asymptomatic erythematous or violaceous atrophic plaques, ranging in size from 2 to 7 (mean 5.8) cm in diameter. Superficial scale was clinically noted in 4 patients. Almost all lesions were located on the lower extremities (hip, thigh, and

Discussion

We describe a previously unreported vascular proliferation with distinctive and reproducible features. It usually presents as an indolent solitary erythematous or violaceous atrophic plaque during or after the 5th decade of life, predominantly in male patients, most commonly on the lower extremities; this proliferation demonstrated a benign clinical course during the available follow-up period (up to 6 years). Histologically, there is a characteristic superficial dermal band-like vascular

References (14)

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Funding sources: None.

Conflicts of interest: None disclosed.

Reprints not available from the authors.

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