Histologic examination of multiple verrucous leg lesions showed sharply demarcated, verrucous epidermal hyperplasia; numerous dilated, papillary,dermal blood vessels adjacent to the epidermis; and subcorneal and dermal erythrocyte extravasation, consistent with angiokeratoma. Differentiationfrom verrucous hemangioma was made on the basis of the lack of deep dermal or subcutaneous extension in all the skin lesions sampled.
Tissue cultures were positive for mixed flora and negative for fungi and mycobacteria. The results of the following laboratory investigations werenormal: blood chemistry profile, complete blood cell count, and 24-hour urine collection. Serologic testing revealed negativity for human immunodeficiencyvirus and normal levels of the following enzymes: α-galactosidase A, α-fucosidase, β-galactosidase, and β-mannidase. Also, electron microscopy revealed no lysosomal inclusionsin the endothelial cells, pericytes, or fibroblasts.
Diffuse Verrucous, Vascular Nodules on the Extremities and Trunk—Diagnosis. Arch Dermatol. 2004;140(3):353–358. doi:10.1001/archderm.140.3.353-b
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