Extensive Acquired Telangiectasias: Comparison of Generalized Essential Telangiectasia and Cutaneous Collagenous Vasculopathy

Abstract

The late development of symmetrical, ascending telangiectasias over an extensive area of the skin with no associated systemic manifestations is a common presentation of generalized essential telangiectasia (GET). It was recently suggested that cutaneous collagenous vasculopathy (CCV) is clinically identical to GET but that the 2 conditions can be distinguished by their distinctive histopathologic findings. We present 2 patients, both women, with multiple telangiectasias and describe the histopathologic findings that led to the diagnoses of GET and CCV. Dermoscopic findings in both cases were similar, except that the older telangiectasias in the patient with CCV were violaceous and distributed in a tortuous, serpentine pattern. During follow-up 12 years for the woman with GET and 42 years for the woman with CCV we saw that in GET the lesions remained stable in appearance whereas in CCV there was progressive darkening and morphological changes eventually resulting in superficial varicose veins.

Pathophysiology of telangiectasias of the lower legs and its therapeutic implication: A systematic review

“…In atypical telangiectasias, this entity must be suspected, and a biopsy with immunohistochemistry must be performed to distinguish GET and CCV. 12 In conclusion, red telangiectasias are definitively veins, as are the blue ones. Why they are more difficult to treat and why they respond less to sclerotherapy remains still unclear.…”

“…Histology reveals fine-wall telangiectasias with flattened endothelial cells with usually no dermal or epidermal abnormalities. 12 There have been reports of treatment success with tetracycline, ketoconazole, acyclovir, sclerotherapy, and vascular laser therapy. 13…”

“…Like generalized essential telangiectasias (GET), it usually appears on the lower leg before ascending gradually and symmetrically on the trunk, upper arms. 12 CCV may be successfully treated with a combination of optimized pulsed light and vascular laser. 11 GET, also from unknown etiology, is mainly a clinical diagnosis.…”

Dermoscopic features of cutaneous collagenous vasculopathy: A report of rare disorder

“…[ 1 ] Till now, more than 28 cases have been reported in the literature. [ 2 ] Brady et al . described CCV in middle-aged adults, equally in both males and females.…”

“…All these findings were absent in our case. [ 2 6 7 ] Thus, with the use of dermoscope, we can easily differentiate vasculopathy from the above two conditions. Further studies will aid in establishing the dermoscopic pattern of CCV.…”