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March 1986

Angiokeratoma Circumscriptum Following Damage to Underlying Vasculature

Arch Dermatol. 1986;122(3):245-246. doi:10.1001/archderm.1986.01660150021005

To the Editor.—  In the August 1985 issue of the Archives, Goldblum and his colleagues1 reported a case of pseudo-Kaposi's sarcoma of the hand associated with an iatrogenic arteriovenous fistula. These authors reviewed the reported complications of arteriovenous fistulas used for chronic hemodialysis. We recently examined a patient in whom an angiokeratoma developed overlying a traumatic arteriovenous fistula. This unusual association appears analogous to the occurrence of lymphangioma circumscriptum in the setting of damaged lymphatic drainage, and suggests that angiokeratoma can also represent a skin manifestation of acquired abnormal blood flow in underlying soft tissues.

Report of a Case.—  A falling door struck a moderately obese 33-year-old carpenter just above the left knee in August 1984, producing a 3 × 12-cm hematoma. The hematoma failed to resolve, and in September an orthopedic surgeon repaired avulsed vastus medialis fascia and evacuated a large organizing hematoma. Also encountered during surgery was a

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