Diffuse dermal angiomatosis (DDA) is a rare, cutaneous vascular disorder described in 1994.1 Initially, it was thought to be a variant of the reactive angioendotheliomatoses in which endothelial cells proliferate within dermal capillaries. In contrast, the endothelial cell proliferation of DDA occurs extravascularly within the dermal stroma. The condition is characterized clinically by painful, poorly circumscribed, erythematous plaques that often exhibit central ulceration.2,3