Targetoid hemosiderotic hemangioma— a dynamic vascular tumor: Report of 3 cases with episodic and cyclic changes and comparison with solitary angiokeratomas

A Recurrent Case of Targetoid Hemosiderotic Haemangioma

“…During this time. THH may undergo episodic and cyclic changes in morphology (2). Complete and spontaneous clearing, as in our patient, has not been reported previously.…”

“…surrounded by a thin, pale area and a peripheral ecchymotic halo. It is generally accepled thai THH does not resolve itself There is no recurrence following excision, although episodic and cyclic morphological changes have been recorded (2). Since its first description, more than 158 cases have been documented, all in Caucasians (3).…”

Dermoscopy of Targetoid Hemosiderotic Hemangioma: A Morphological Study of 35 Cases

“…Like some authors, we consider THH a hemosiderotic lymphatic malformation [1,2] and all dermoscopic patterns as different evolutive phases of THH formation [3,6,17]. In the initial stages, a precipitating factor (traumas or hormonal factors [1,2] have been postulated) could lead to the development or expansion of micro-shunts in which the pressure of the capillaries would cause filling of the lymph spaces of the lesion with erythrocytes and contribute to the formation of aneurysmal microstructures.…”

Clinicopathologic challenge

“…Other studies have suggested a lymphatic origin for these lesions, supported by the general lack of CD34 staining and limited actin‐positive pericytes 5,6 . Cyclical variation in palpability, size, and hue of these lesions has been reported on several occasions 4,7,8 . One study reported an association with pregnancy or the menstrual cycle, with vasoreactivity secondary to estrogen and progesterone as a proposed mechanism 8 …”

“…Multiple etiologic mechanisms have been proposed. One well‐accepted mechanism is that of a THH developing from trauma to a pre‐existing hemangioma 2–4 . Other studies have suggested a lymphatic origin for these lesions, supported by the general lack of CD34 staining and limited actin‐positive pericytes 5,6 .…”