Kaposi-like acroangiodermatitis induced by a suction-socket prosthesis

Progressive erythematous plaques in a young man

“…Acroangiodermatitis may be associated with chronic venous insufficiency, thrombophilic disorders, stump dermatosis in amputees, and with some vascular abnormalities such as Klippel–Trenaunay syndrome, or arteriovenous malformations . Impairment in the venous flow and a disturbed vascular innervation has been hypothesized playing a possible role in its development …”

Nonhealing Ulcer: Acroangiodermatitis of Mali

“…Acroangiodermatitis (pseudo-Kaposi sarcoma) is a chronic dermatosis and is associated with venous insufficiency or with vascular anomalies of any cause such as Klippel-Trenaunay syndrome as discussed by Lyle and Given [1] or as stump dermatosis in amputees as shown in the work by Badell et al [2]. It has been reported in patients with a thrombophilic prothrombin mutation as discussed by Martin et al [3], in upper limbs following placement of arteriovenous shunt for hemodialysis as shown by the extensive work by Fernández et al [4], in the paralyzed limb as shown by the study of Landthaler et al [5], and hepatitis C. It is more prevalent in males.…”

Pseudo‐Kaposi’s sarcoma because of suction‐socket lower limb prosthesis

“…Lesions identical to those of acroangiodermatitis of Mali may be seen in the distal part of an amputation stump, and reports of acroangiodermatitis have appeared in the literature more frequently because the increased use of the suction‐socket prosthesis that uses suction as a mechanism for securing the socket to the stump by using a valve system to create negative pressure in the stump‐socket environment. In these cases, pseudo‐Kaposi’s sarcoma is probably caused by the negative pressure in the stump‐socket environment, leading to altered local circulation and the proliferation of small vessels 16 . Repeated microtrauma to the skin of the stump may occur if the fit of socket and stump is not perfect, leading to proliferation of fibroblasts and small vessels and in particularly sensitive tissue such as the skin on an amputation stump 17 .…”

“…Repeated microtrauma to the skin of the stump may occur if the fit of socket and stump is not perfect, leading to proliferation of fibroblasts and small vessels and in particularly sensitive tissue such as the skin on an amputation stump 17 . Acroangiodermatitis occurring on amputation stumps because of socket prostheses is clinically reported as a stump edema with violaceous macules, patches and nodules 2,16,17 . There is one report of amputation stump dermatitis, clinically resembling verrucous hyperplasia, but with predominant histologic aspects of acroangiodermatitis in a patient with a suction‐socket lower limb prosthesis 11 …”