ABSTRACT
Angiokeratoma is a benign vascular proliferation composed of dilated capillaries in the upper dermis associated with epidermis overgrowth. Angiokeratomas are more frequent in men and affect approximately 0.16% among the general population. Angiokeratomas generally occur in males on the scrotum and less often on the penis, in females on the labia majora and rarely on the labia minora or on the clitoris. The diagnosis of angiokeratoma is generally clinical, and histopathological examination is rarely indicated. However, especially when the lesion appears dark purple or black, the diagnosis may be more difficult simulating a pigmented lesion. The well-demarcated red/dark lacunae and the whitish veil seen at dermoscopy correspond to the wide dilated vascular spaces, that may be partially or completely thrombosed, and to hyperkeratosis and acanthosis, respectively. The star-like brown pattern and the hypopigmented areas histopathologically correspond to follicular plugging and to epidermal atrophy with lack of pigment.
