Diffuse dermal angiomatosis D21.9

Nurse and Tappeiner 1959

Reactive, self-limited, realtively inflammatory, lymphoreticular disease that can occur in the context of systemic diseases such as bacterial endocarditis, rheumatoid arthritis, cryoglobulinemia, and monoclonal gammopathy. The disease is an expression of intravascular endothelial proliferation, mrist triggered by fibrin thrombus or cryoprotein thrombus.

Reactive angioendotheliomatosis must be distinguished from the malignant form of angioendotheliomatosis, which is considered intravascular lymphoma(intravascular cutaneous large cell lymphoma).

Very rare; < 100 cases are described in world literature. No sex preference.

Cryoglobulins, cold agglutinins and phospholipid antibodies were detected in a group of patients. In other cases, endoprophetic surgery was performed. A release of angiogenesis factors is assumed within the framework of the underlying disease.

Disease pattern limited to the skin, multifaceted and thus clinically not very groundbreaking. Mostly formation of solitary, asymptomatic, blurred, reticular or homogeneous extensive redness. But also disseminated, indurated, small or large plaques have been described, as well as subcutaneous nodules. More rare are papular or plaque-shaped exanthema interspersed with petechiae, sometimes with the aspect of a livedo.

Proliferation of densely packed solid and luminaceous capillaries that form networks in places. The vascular cavities are lined with clumsy endothelial cells that protrude into the lumens. No cell atypia, no increased proliferation tendency of the endothelial proliferates.

Malignant angioendotheliomatosis (considered intravascular T-cell or B-cell lymphoma; histologic differentiation; systemic involvement).

Polyarteritis nodosa, cutaneous: palpable purpura, rarely livedo, urticarial exanthema, subcutaneous nodules with pyoderma gangraenosum-like ulcerations. Frequently pulmo-renal syndrome.

Erythema nodosum: acute; painful. Localization mainly on the lower legs.

Early forms of mycosis fungoides: Histology is diagnostic.

Kaposi's sarcoma (colour red-brown, arranged in the tension lines of the skin)

Angiosarcoma: mostly occurring in older people; development here in the area of prolonged lymphoedema (e.g. following mastectomy and lymphadenectomy), after radiotherapy and immunodeficiencies (e.g. HIV infection). When angiosarcomas occur after radiotherapy, the irradiation usually took place at least 5-6 years ago; longer intervals are not uncommon and can extend over decades.

Lymphangiosis carcinomatosa of visceral neoplasms: coarse clinically mostly uncharacteristic plaques.

Symptomatic

Symptomatic

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