CASE REPORT

Year: 2019 I Volume: 2 I Issue: 2 I Page: 58

A Rare Case Of Angioma Serpiginosum

Dr. Satyendra Kumar Singh¹, Dr. Nidhi Singh¹, Dr. Tulika Rai¹, Dr Ayushi Bohara¹

¹ Department of Dermatology & Venereology, B.H.U

Corresponding Author:
Nidhi Singh

How to cite this article:
Singh SK, Singh N, Rai T, Bohara A. A rare case of Angioma serpiginosum.JDAIndianJournalofClinicalDermatology.2019;2:58.

Abstract:

Angioma serpiginosum, a rare vascular nevoid disorder due to ectatic dilation of capillaries in the papillary dermis, is found almost exclusively in females. Affected individuals tend to have grouped erythematous punctate lesions on the lower limbs or buttocks.

Key words: Angioma serpiginosum, vascular nevoid disorder

Introduction:

Angioma serpiginosum, a rare vascular nevoid disorder due to ectatic dilation of capillaries in the papillary dermis, is found almost exclusively in females. It was first described by Hutchinson in 1889.^[1] Affected individualstend to have grouped erythematous punctate lesions on the lower limbs or buttocks.

Case Report:

A 26 year-old man presented to our dermatology department, with complaint of asymptomatic red, non raised skin lesions over left half ofthe neck, left upper part of abdomen and penis for 11 years. The patient’s and family medical history were unremarkable. On examinationtherewerewell areasofmultiple,small, asymptomatic, non-palpable, red punctate macules organized in smallsheets over leftside of neck, left upper part of abdomen and penis(figure no.1 & 2). Laboratory investigations like complete blood count, liver function test, renal function test, bleeding time and clotting time were within normal limit. Histopathologic examination of skin biopsy from abdomen, revealed multiple areas of congested dilatedcapillariesin thepapillarydermis(figureno.3).

Discussion:

Angioma serpiginosumis a rare, benign, acquired, vascular nevoid condition. It has female preponderance and mainly affects lower extremities and buttocks. The condition is an asymptomatic. It usually startsin early childhood and stabilizesin adults. It israrely undergo complete spontaneous involution. Clinically, lesions are copper to bright red, punctate, non-blanchable or partially blanchable, grouped maculesthat may develop into papules with a background of erythema. Lesions enlarge by developing new lesions at the periphery with clearing of lesions in the center and thisleadsto a serpiginous orgyrate ringlikemorphology.^[2]

It has no known etiology. Estrogen was considered to be an important hormone in the development of angioma serpiginosum supporting the role of hormones for the cause of increased incidence of angioma serpiginosum in women.^[3] However, recently, the role of hormones in its pathogenesis was disproved due to the absence of estrogen and progesterone receptors on the involved blood vessels.^[4]

Figure 1: Sheet of red macule over left side of neck. Click here to view

Figure 2: Sheet of red macule over left upper aspect of abdomen. Click here to view

Figure 3: Congested dilated capillaries in papillary dermis. (HPE 100×) Click here to view

References:

1. Chen JH, Wang KH, Hu CH, Chiu JS. Atypical angioma serpiginosum.YonseiMed J2008;49:509-13.

2. Namazi MR, Handjani F.Angioma serpiginosum. Dermatol Online J2003;9:19

3. Xiao X, Hong L, Sheng M. Promoting effect of estrogen on the proliferation of hemangioma vascular endothelial cellsin vitro.JPediatrSurg1999;34:1603-5.

4. Bayramgurler D, Filinte D, Kiran R.Angioma serpiginosum with sole involvement.EurJDermatol2008;18:708-9.

5. IlknurT, Fetil E,Akarsu S,Altiner DD, UlukusC, GünesAT. Angioma serpiginosum: Dermoscopy for diagnosis, pulsed dye laserfortreatment.JDermatol2006;33:252-5.