Diffuse dermal angiomatosis associated with severe atherosclerosis: two cases and review of the literature

Abstract

Diffuse dermal angiomatosis (DDA) is a rare condition characterized by endothelial proliferation in the reticular dermis. Several diseases have been associated with DDA, including peripheral arterial disease (PAD). We report two cases of DDA associated with PAD. Patient 1 was a 71-year-old woman, who presented with painful necrotic ulcerations on her trunk and a medical history of PAD. Skin biopsy revealed a dermal proliferation of endothelial cells, and despite medical treatment, she died 1 month later. Patient 2 was an 81-year-old man, who presented with an erythematous, bluish plaque of the shoulder. He was a heavy smoker, with severe PAD. Biopsy showed dermal capillary hyperplasia, with a few fibrin thrombi, and follow-up only was recommended. In both cases, laboratory tests and Doppler ultrasonography ruled out other thrombotic conditions and vascularitis. DDA is a rare complication of PAD, and the optimum medical treatment remains to be clarified, especially when revascularization has failed or is not possible, as in our cases.

Diffuse dermal angiomatosis associated with calciphylaxis: A 5‐year retrospective institutional review

“…Although severe atherosclerosis has been previously reported in cases of DDA; CHF was the only significant cardiovascular abnormality we identified. 85.7% of biopsies with associated DDA were from patients with diagnosed CHF vs 29.4% biopsies in the DDA negative group, which was statistically significant after controlling for African American race in this study.…”

“…Diffuse dermal angiomatosis (DDA) is a rare, acquired, reactive cutaneous vascular disorder initially reported in 1994 by Krell et al to describe a distinct variant of benign reactive angioendotheliomatosis. Histopathologically, DDA displays a diffuse interstitial proliferation of endothelial cells forming small caliber vessels within the superficial layers of the papillary and reticular dermis . DDA is hypothesized to be a reactive process secondary to local ischemia, possibly through vascular endothelial growth factor production .…”

“…Histopathologically, DDA displays a diffuse interstitial proliferation of endothelial cells forming small caliber vessels within the superficial layers of the papillary and reticular dermis . DDA is hypothesized to be a reactive process secondary to local ischemia, possibly through vascular endothelial growth factor production . Several diseases have been associated with DDA, including peripheral arterial disease, CP, arteriovenous fistulas, and macromastia …”

“…DDA is hypothesized to be a reactive process secondary to local ischemia, possibly through vascular endothelial growth factor production . Several diseases have been associated with DDA, including peripheral arterial disease, CP, arteriovenous fistulas, and macromastia …”

Diffuse Dermal Angiomatosis: A Clue to the Diagnosis of Atherosclerotic Vascular Disease

“…In addition, all reported patients had multiple atherosclerotic comorbidities such as hypertension, dyslipidemia, diabetes mellitus, chronic kidney disease and heavy smoking. Most of them had undergone revascularization procedures, and all lesions rapidly healed shortly after the procedures [ 2 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. However, one reported patient who received conservative medical therapy, which included oral prednisolone and colchicine, died from severe sepsis.…”