ABSTRACT
Angioma, pyogenic granuloma, and angiokeratoma are vascular proliferations very common in the general population that display distinctive features under dermoscopy. The most characteristic dermoscopic feature of cherry angiomas is the presence of numerous round or oval well-demarcated red to purple-bluish lacunae. Histologically, these structures correspond to large dilated vascular spaces in the superficial dermis. Trauma to lymphatic vessels with the development of lymphatic vascular microshunts seems to play a key role in the pathogenesis, resulting in dilated vascular spaces with hobnailed endothelial cells, extravasation of red blood cells and hemosiderin deposits, fibrosis, and inflammation. Pyogenic granuloma is dermoscopically characterized by homogeneous reddish or white-reddish areas surrounded by a whitish collarette. The dermoscopic pattern most often seen in solitary angiokeratoma consists of dark lacunae, white-yellow keratotic areas, and a whitish veil. Dark lacunae histologically correspond to dilated vessels in the dermis, which are often partially or totally thrombosed.
