Collagenous vasculopathy: a report of three cases

Abstract

Cutaneous collagenous vasculopathy (CCV) is an idiopathic microangiopathy involving the superficial blood vessels that was initially reported in a 54-year-old male. We recently have identified this rarely reported entity in three Caucasian males. The first patient was a 59-year-old male with diabetes, hypertension and hypercholesterolemia who presented with multiple, red, blanchable, asymptomatic telangiectasias covering the extensor surface of the forearms, the lower abdomen and parts of the chest. The second patient was a 62-year-old male with psoriasis and extensive arthritis who presented with prominent telangiectasias on the left lateral distal thigh with mild overlying epidermal atrophy. The third patient was an 80-year-old male with atrial fibrillation who presented with blanching, telangiectatic areas on the abdomen, thighs and back. Histologically, the skin lesions showed ectatic superficial small blood vessels with laminated, hyalinized concretions around vessels that were highlighted with periodic acid-Schiff staining following diastase digestion and reactive by immunohistochemical staining with an antibody to collagen type IV. CCV is a rare and poorly understood entity with distinct histopathological features that may clinically resemble generalized essential telangiectasia (GET), yet which may affect a different demographic population than GET. Awareness of this uncommon entity may further help to elucidate its etiology.

Cutaneous Collagenous Vasculopathy: Description of Two New Cases in Elderly Women and Review of the Literature

“…In the cases described so far, the affected vessels were located in the superficial papillary dermis [1,2,3,4,5,6]; however, in our second case the vessels of the reticular dermis were also affected.…”

“…In most cases, the lesions began in the distal leg area and progressed proximally reaching the thighs, trunk and upper extremities [2]. However, in 1 patient the arms and abdomen were predominantly affected, with little involvement of the lower extremities [3]. In another case the lesions affected only 1 leg [3].…”

“…This thickening is due to deposition of eosinophilic material around the endothelial basal lamina showing positivity with PAS staining and is stained blue with Masson trichrome. Mucinous material is often found [1,2,3,4,5,6] in this deposit. It has been reported that collagen IV, fibronectin and laminin are positive [1,2] but in our case No.…”

“…However, in 1 patient the arms and abdomen were predominantly affected, with little involvement of the lower extremities [3]. In another case the lesions affected only 1 leg [3]. In most cases the lesions had been present for several years before the consultation.…”

“…In some cases, however, this is not specified [3]. So far no disease or drug has been found that is consistently associated with CCV.…”