Angiokeratoma: Types, Symptoms, Causes, Diagnosis and Treatment

It is a non-malignant lesion formed by capillaries that gives rise to small dark red to dark blue marks on the skin.

The condition is manifested by hyperkeratosis or thickening of the outermost layer of the epidermis. Vascular lesions may be unique and discrete or arranged in groups and usually do not bleach when applied with pressure.

Types

The benign condition is classified into several types according to the location of these warty elevations. These include:

Sporadic angiokeratoma

In this type, solitary lesions are present randomly in the body’s lower extremities. It is a common dermatological disorder in middle-aged adults.

Angioqueratoma de Fordyce

The condition is usually marked by a single lesion or multiple papular growths in the scrotum of the males.

Small, raised, dark red to purple spots can also appear on the shaft of the penis, the inside of the thigh, or the lower part of the abdomen.

Angioqueratoma circusciptum

Abnormal groups of blood vessels that occur during fetal development may manifest unilaterally in a group of lesions in the torso or lower leg and, sometimes, in the thighs.

 

As time passes, the lesions may change shape and size. The condition is rare, but it has morphological similarities with malignant melanoma or pigmented basal cell carcinoma.

Angioqueratoma vulvar

In this type, solitary or multiple lesions occur in the vulva of women who are over 50 years old.

Angiokeratoma of mibelli

The condition is characterized by 1-5 mm red vascular bumps in the skin. In the later stages, the surface of the lesions thickens to give a scaly or warty skin.

This vascular and cutaneous disorder is known as “Mirabelli angiokeratoma” or “telangiectatic warts.”

Symptoms of Angiokeratoma

The main clinical presentations of the condition are given below:

Telagientasias

Small, dilated blood vessels, measuring 0.5-1 mm in diameter, are widely found near the surface of the skin or mucous membranes.

They can develop anywhere on the body but are commonly seen on the face, especially the nose, cheeks, or chin.

Acanthosis

In affected patients, the spinous layer of the epidermis undergoes thickening and leads to the formation of warts on the skin and mucosal layers.

Causes

The dermatological condition is often associated with angiokeratoma corporis difusum / Fabry syndrome, a rare recessive disorder linked to the X chromosome marked by an alpha-galactosidase deficiency.

The lysosomal enzyme is necessary to metabolize lipids, substances similar to fats that include oils, waxes, and fatty acids.

In Fabry syndrome, however, the mutation in the gene that controls alpha-galactosidase causes the accumulation of globotriaosylceramide in the vascular endothelium, smooth muscle cells, kidney, myocardium, and nervous system.

Symptoms usually arrive before puberty and include:

  • Dilation of blood vessels in the genital areas.
  • Edema.
  • Cardiomegaly.
  • Diffuse the nodularity of the skin.

Diagnosis of Angiokeratoma

The physical inspection of the affected skin, for further investigation, the biopsy of abnormal growth can confirm the condition and rule out the presence of other skin disorders.

Patients with suspected Fabry syndrome may require a simple blood test to measure the level of alpha-galactosidase. Generally, a renal biopsy is recommended to evaluate the amount of intraglomerular lipids.

Treatment

The severity of vascular injuries can be reduced by using the following therapeutic methods:

Surgical excision

The affected tissue is usually removed using a scalpel before grafting the skin.

Terapia Laser

Carbon dioxide lasers are used to vaporize and seal the affected layers of the skin. This non-invasive technique promotes the development of a new layer of skin in the treated area.

Cryotherapy

The method involves the application of extreme cold to destroy diseased tissues. In this procedure, the liquid nitrogen or argon gas flows into a needle-type applicator, which comes in contact with the damaged skin.

In this way, painful lesions are eradicated to result in improved skin.