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

Abstract

Poikilodermatous plaque-like hemangioma (PPLH) is a recently described benign vasoformative entity with only 16 cases reported to date. We present an additional case of a 90-year-old male who presented with a 2-year history of a relatively large, asymptomatic, atrophic plaque on his left buttock. The lesion was initially smaller and

Erythematous Plaque on the Lower Extremity of an Older Adult Man

“…It is typically located on the lower extremity of older adult men and commonly described as a slowly growing, asymptomatic, solitary, erythematous-violaceous plaque with an overlying cigarettepaper wrinkling that gives an atrophic appearance. 1,2 Histologically, there is a band-like vascular proliferation in the papillary and superficial reticular dermis within a sclerotic stroma with no clear separation from the epidermis. The vessels are lined by a single layer of endothelial cells with absent mitotic activity.…”

“…To our knowledge, only 17 cases of PPH have been reported. It is typically located on the lower extremity of older adult men and commonly described as a slowly growing, asymptomatic, solitary, erythematous-violaceous plaque with an overlying cigarette-paper wrinkling that gives an atrophic appearance …”

An Elderly Man With a Violaceous Plaque on the Right Buttock: Answer

“…1,2 VEGF is expressed by keratinocytes and vascular endothelial cells 3 and activates VEGFR-2 on blood endothelial cells in the lesional dermis. 4 Poikilodermatous plaque-like hemangioma (PPLH) is another newly described entity 5,6 that shares similar clinical and histologic features with prurigiform angiomatosis. In a retrospective study by Semkova et al, they report PPLH in 16 patients who presented with a solitary erythematous-toviolaceous poikilodermatous atrophic plaque on the lower extremities and pelvic region.…”

“…5 Histologic features of PPLH include epidermal acanthosis and hyperkeratosis, a diffuse band-like vascular proliferation of postcapillary venules in the underlying dermis, dermal fibrosis, and edema. 5,6 It is possible that prurigiform angiomatosis and PPLH are different terms for the same entity or reactive angioproliferative processes within the same spectrum. They both present clinically as asymptomatic, atrophic appearing erythematous-to-violaceous plaques on the lower extremities or pelvic region in elderly men.…”

“…They both present clinically as asymptomatic, atrophic appearing erythematous-to-violaceous plaques on the lower extremities or pelvic region in elderly men. 1,5,6 Prurigiform angiomatosis was reported to occur more frequently on pressure areas including the buttock and gluteal fold, 1 whereas PPLH occurred more commonly on the hip, thigh, and lower leg. 5…”