Scrotal and vulval angiosclerosis D23.9

Author: Prof. Dr. med. Peter Altmeyer

Last updated on: 30.06.2022

Synonym(s)

angiokeratoma fordyce; angiokeratoma of fordyce; angiokeratoma of the scrotum (Fordyce type); angiokeratoma punctiformis scroti sive vulvae; angiokeratoma scroti sive vulvae

History
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Fordyce 1896

Definition
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Circumscribed vascular ectasia(angiokeratoma) on the scrotum, vulva, more rarely also on the glans penis (there disseminated or strung in the area of the corona glandis).

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Vascular medicine

Angiokeratoma circumscriptum

Not quite rare, unilateral, mostly monotopic, gynecotropic, venous malformation mainly of the lower extremity.

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Etiopathogenesis
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Triggering by increased venous pressure (varicocele) is being discussed.

Manifestation
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Occurring in old age.

Localization
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Scrotum, vulva, glans penis

Clinical features
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Isolated or multiple, mostly disseminated, but also grouped, pinhead to lenticular, first light, then blue-red papules or vesicles with mostly smooth, occasionally scaly or verrucous, sometimes eroded surface. No significant growth tendency. Occasional wetting or bleeding possible. Otherwise no symptoms.

Histology
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Dilated capillaries in the papillary stratum, partly enclosed by elongated retele strips.

Diagnosis
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Clinical picture is diagnostic. Histological confirmation if necessary.

Differential diagnosis
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Angiokeratoma corporis diffusum; Kaposi sarcoma.

Therapy
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In most cases not necessary, since completely harmless. In case of increased bleeding tendency or a pronounced desire for therapy, coagulation, laser treatment ( argon laser) or excision.

Note(s)
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The term "angiokeratoma" is not applicable in the context of this clinical picture and is not comparable to other diseases which are also called "angiokeratomas" (e.g. Angiokeratoma Mibelli, Angiokeratoma circumscriptum), but rather to pure vascular ectasia (Venous lakes) comparable to vascular ectasia in other localisations.

Case report(s)
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angiokeratomas of the penis

In a 53-year-old, otherwise healthy patient, an increasing number of symptom-free, soft, completely painless red to red-blue papules have appeared for several years. The surface is smooth, occasionally slightly roughened with fine scales.

Diagnosis: A histological examination was not performed because of the clear clinical findings.

Diagnosis: Angiokeratomas of the penis

Therapy: The patient should be informed in detail about the harmlessness of the findings. A therapy is not necessary.

Literature
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Bechara FG, Altmeyer P, Jansen T (2004) Unilateral angiokeratoma scroti: a rare manifestation of a vascular tumor. J Dermatol 31: 39-41
Fordyce JA (1896) Angiokeratoma of the scrotum. J Cutan Genitourin Dis 14: 81-87
Jansen T, Bechara FG, Stucker M, Altmeyer P (2002) Angiokeratoma of the scrotum (Fordyce type) associated with angiokeratoma of the oral cavity. Acta Derm Venereol 82: 208-210
Miller C, James WD (2002) Angiokeratoma of Fordyce as a cause of red scrotum. Cutis 69: 50-51