Acquired elastotic hemangioma‐like changes and eccrine sweat duct squamous metaplasia in lichen simplex chronicus/prurigo nodularis‐like lesions of the knee and elbow

Kacerovská, Denisa; Portelli, Francesca; Michal, Michal; Kazakov, Dmitry V.

doi:10.1111/cup.12945

Cited by 12 publications

(6 citation statements)

References 51 publications

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“…These lesions are characterized by a band‐like proliferation of capillary blood vessels in the papillary and superficial reticular dermis arranged parallel to and separated from the epidermis by a thin area of uninvolved papillary dermis (grenz zone) with elastic fibers between the vessels 10 . Similar capillary proliferations have also been described in select cases of lichen simplex chronicus/prurigo nodularis‐like lesions of the knee and elbow on sun‐damaged skin of middle‐aged and elderly patients, suggesting a possible component of trauma, not noted in the original series of PPLH or in our case, in the etiopathogenesis 12 . In contrast, microvenular hemangioma typically occurs in younger adults, presents as solitary red‐purple plaques or nodules on the trunk and extremities and is characterized by an ill‐circumscribed proliferation of monomorphic small blood vessels with indistinct collapsed lumina in the superficial and deep dermis 11 …”

Section: Discussionsupporting

confidence: 85%

Poikilodermatous plaque‐like hemangioma: A benign vasoformative entity with reproducible histopathologic and clinical features

Sullivan

Hartman

Mahalingam³

2020

J Cutan Pathol

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Section: Discussionsupporting

confidence: 85%

Poikilodermatous plaque‐like hemangioma: A benign vasoformative entity with reproducible histopathologic and clinical features

Sullivan

Hartman

Mahalingam³

2020

J Cutan Pathol

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“…The pathologic differential diagnosis of acquired elastotic hemangioma includes benign (such as acquired tufted hemangioma, angioma, and targetoid hemosiderotic hemangioma) and malignant (such as angiosarcoma, Dabska tumor, Kaposi sarcoma, and retiform hemangioendothelioma) vascular lesions (Table 7 ) [ 1 - 2 , 4 , 7 , 9 , 11 , 13 - 15 ]. The endothelial cells that line the vascular channels in acquired elastotic hemangioma can be plump and protrude into the vessel lumina in a hobnail pattern; therefore, other vascular proliferations with a hobnail pattern (such as angiosarcoma, Dabska tumor, retiform hemangioendothelioma, and targetoid hemosiderotic hemangioma) need to be considered and excluded.…”

Section: Discussionmentioning

confidence: 99%

“…Also, reactive vascular lesions—such as pseudo-Kaposi sarcoma (acroangiodermatitis of Mali and Stewart-Bluefarb syndrome)—are in the pathologic differential diagnosis. Recently, Kacerovska, et al [ 15 ] described a reactive lesion of not only vascular elements but also epithelial and eccrine sweat ducts that occurs on the knee and the elbow—sites associated with chronic pressure or repeated mechanical stimulation. The vascular changes in these lesions are similar to those observed in acquired elastotic hemangioma; however, there is also squamous metaplasia of the eccrine ducts and epithelial changes consistent with lichen simplex chronicus and prurigo nodularis.…”

Section: Discussionmentioning

confidence: 99%

Acquired Elastotic Hemangioma: Case Series and Comprehensive Literature Review

Cohen

Hinds

2017

Cureus

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BackgroundAcquired elastotic hemangioma is a benign vascular proliferation that typically presents as an asymptomatic red plaque on a sun-exposed site of an adult.Material and MethodsThe PubMed database was used to search the following words: acquired, angioma, arm, basal, carcinoma, cell, elastosis, elastotic, exposed, forearm, hemangioma, solar, sun, and vascular. The relevant papers and reference cited generated by the search were reviewed. The features from a case series of 11 patients with acquired elastotic hemangioma are presented. In addition, a comprehensive review of the characteristics of this unique hemangioma—not only in our 11 patients but also in the previously reported 34 individuals with this lesion—is provided.ResultsAcquired elastotic hemangioma, reported in 45 patients (24 women and 21 men), typically appeared as an asymptomatic solitary red plaque in sun-exposed areas—most commonly the forearm--of adults aged 50 years or older. The pathology shows a proliferation of vascular channels—surrounded and intertwined by intense solar elastosis--in the upper dermis, located parallel to the overlying epidermis, and separated from it by a zone of normal-appearing superficial papillary dermis. There was extensive solar elastosis surrounding and between the new blood vessels; some of the endothelial cells protrude (in a hob-nail pattern) into the vessel lumen. The clinical differential diagnosis includes basal cell carcinoma and the pathologic differential diagnosis includes other benign, malignant, and reactive vascular lesions. Ultraviolet radiation may contribute to the pathogenesis of this hemangioma since it occurs on sun-exposed sites. There was no recurrence of the lesion following either excision or observation.ConclusionsThe possibility of acquired elastotic hemangioma should be considered by clinicians when they encounter an older individual with a new red plaque on a sun-exposed site that clinically appears to be a superficial basal cell carcinoma.

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“…Kacerovska et al 4 described a type of reactive vascular proliferation closely resembling AEH associated with lichen simplex chronicus/prurigo nodularis-like lesions showing predilection for knee and elbow that they considered related to chronic pressure or repeated mechanical stimulation.…”

mentioning

confidence: 99%

Acquired Elastotic Hemangioma-like Change of the Vulva Associated With Lichen Sclerosus

Val‐Bernal

Hermana

Aller

2021

International Journal of Gynecological Pathology

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Acquired elastotic hemangioma (AEH) is a rare variant of hemangioma that usually presents as an asymptomatic, solitary, slow-growing red plaque on a sun-exposed site of an adult. Ultraviolet radiation can contribute to the pathogenesis of this hemangioma. Lichen sclerosus (LS), a scarring disease, may present a prominent accumulation of elastic fibers in the reticular dermis reflecting a reparative process. Vulvar elastosis, a novel diagnostic entity with fibers similar to solar elastosis, is more common in women 45 yr and older and is related to aging and/or hormonal changes. We herein report for the first time a case of AEH-like change located in the vulva, a sun-protected area, associated with genital LS. An 81-yr-old woman presented with a painful vulvar lesion of 1-yr duration. Clinical examination revealed vulvar LS and 1 cm-flat, erythematous, well-defined plaque with increased consistency located on the left labium minus. Histopathology showed a non-neoplastic proliferation of WT1-positive, small vascular channels surrounded and intertwined by intense elastosis in the reticular dermis. Alpha-smooth muscle actin positive pericytes encircled the vascular channels. The lesion can be understood as a reparative process within an LS with the appearance of epidermal hyperplasia, proliferation of small vascular channels, and hyperplastic elastosis. There is a close link between epidermal hyperplasia and angiogenesis in the formation of this reparative lesion. Recognition of this lesion is crucial to avoid confusion with other significant processes especially Kaposi sarcoma and well-differentiated angiosarcoma.

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Acquired elastotic hemangioma‐like changes and eccrine sweat duct squamous metaplasia in lichen simplex chronicus/prurigo nodularis‐like lesions of the knee and elbow

Cited by 12 publications

References 51 publications

Poikilodermatous plaque‐like hemangioma: A benign vasoformative entity with reproducible histopathologic and clinical features

Poikilodermatous plaque‐like hemangioma: A benign vasoformative entity with reproducible histopathologic and clinical features

Acquired Elastotic Hemangioma: Case Series and Comprehensive Literature Review

Acquired Elastotic Hemangioma-like Change of the Vulva Associated With Lichen Sclerosus

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