eMedicine Specialties > Dermatology > Benign Neoplasms

Angiokeratoma of the Scrotum: Follow-up

Author: Amor Khachemoune, MD, CWS, Clinical Instructor, Mohs Micrographic Surgery, Department of Dermatology, State University of New York Downstate Medical Center; Consulting Staff, Department of Dermatology, Veterans Affairs Medical Center of Brooklyn
Coauthor(s): Yoon-Soo Bae-Harboe, MD, General Surgery Intern, New York-Presbyterian Hospital of Weill Cornell Medical College; Marianna Larisa Blyumin, MD, Staff Physician, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine
Contributor Information and Disclosures

Updated: Sep 25, 2009

Follow-up

Further Outpatient Care

  • If a surgical procedure is performed, follow-up care at 3 months post treatment is indicated to assess the cosmetic result and to look for recurrences.

Complications

  • As mentioned previously, bleeding is the only major complication that angiokeratoma patients experience.

Prognosis

  • Spontaneous resolution is not described. The angiokeratomas persist unless treated. Patients with multiple angiokeratomas are more likely to have recurrences after treatment than those with few or solitary angiokeratomas.

Patient Education

  • In most cases of angiokeratoma, the patient, and when appropriate the partner, should be reassured that the condition is common, benign, and does not represent any form of sexually transmitted disease. More lesions may develop with increasing age.

Miscellaneous

Medicolegal Pitfalls

  • The most ominous clinical differential diagnostic consideration is malignant melanoma. Angiokeratomas are composed of superficial vessels immediately subjacent to the epidermis, and because of the common occurrence of intraepidermal hemorrhage and subepidermal thrombosis, the lesions appear deeply pigmented or black from a clinical standpoint, and thus simulate the clinical appearance of melanoma. If the diagnosis is in doubt, then the patient should be referred to a dermatologist to examine the lesion and to perform a biopsy, if needed. Epiluminescent examination (dermoscopy examination) also can be useful in the distinction of a vascular from a melanocytic neoplasm.
  • Fordyce angiokeratomas also must be distinguished from angiokeratomas of Fabry disease. Patients with Fabry disease may report lancinating limb pain or a history of renal disease. Routine histology sometimes demonstrates vacuoles within endothelial cells in patients with Fabry disease. Electron microscopy may demonstrate lamellated inclusion bodies within endothelial cells. Fabry disease should be considered when angiokeratomas are present on the shaft, sacrum, or suprapubic areas in addition to the scrotum.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors Joseph J. Shaffer, MBBS, Vincent A. de Leo, MD, to the development and writing of this article.



More on Angiokeratoma of the Scrotum

Overview: Angiokeratoma of the Scrotum
Differential Diagnoses & Workup: Angiokeratoma of the Scrotum
Treatment & Medication: Angiokeratoma of the Scrotum
Follow-up: Angiokeratoma of the Scrotum
Multimedia: Angiokeratoma of the Scrotum
References
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Further Reading

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Keywords

angiokeratoma of the scrotum, angiokeratoma of Fordyce, Fordyce angiokeratoma, vulvar angiokeratoma

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Contributor Information and Disclosures

Author

Amor Khachemoune, MD, CWS, Clinical Instructor, Mohs Micrographic Surgery, Department of Dermatology, State University of New York Downstate Medical Center; Consulting Staff, Department of Dermatology, Veterans Affairs Medical Center of Brooklyn
Amor Khachemoune, MD, CWS is a member of the following medical societies: American Academy of Dermatology, American Academy of Wound Management, American College of Mohs Micrographic Surgery and Cutaneous Oncology, American Medical Association, American Society for Dermatologic Surgery, and American Society for Laser Medicine and Surgery
Disclosure: Nothing to disclose.

Coauthor(s)

Yoon-Soo Bae-Harboe, MD, General Surgery Intern, New York-Presbyterian Hospital of Weill Cornell Medical College
Yoon-Soo Bae-Harboe, MD is a member of the following medical societies: American Medical Student Association/Foundation
Disclosure: Nothing to disclose.

Marianna Larisa Blyumin, MD, Staff Physician, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine
Marianna Larisa Blyumin, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Medical Women's Association, American Society for Dermatologic Surgery, Dermatology Foundation, Medical Dermatology Society, and Women's Dermatologic Society
Disclosure: Nothing to disclose.

Medical Editor

Timothy McCalmont, MD, Director, UCSF Dermatopathology Service, Professor of Clinical Pathology and Dermatology, Departments of Pathology and Dermatology, University of California at San Francisco
Timothy McCalmont, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, American Society of Dermatopathology, California Medical Association, College of American Pathologists, and United States and Canadian Academy of Pathology
Disclosure: Apsara Consulting fee Independent contractor

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Managing Editor

Edward F Chan, MD, Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine
Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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