Angiokeratoma of the Scrotum Workup

Updated: Aug 07, 2017
  • Author: Yoon-Soo (Cindy) Bae, MD; Chief Editor: Dirk M Elston, MD  more...
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Imaging Studies

Imaging studies are not warranted in the evaluation of angiokeratomas.



Dermoscopy can assist with the diagnosis. Angiokeratoma is characterized by large, well-demarcated, round-to-oval, and red-to-black areas, which are lacunar. In addition, a white surrounding veil corresponds to the acanthotic and hyperkeratotic epidermis. [17]

If the diagnosis is in doubt, then a skin biopsy is recommended.


Histologic Findings

Numerous dilated, thin-walled vessels are positioned in the papillary dermis or superficial submucosa, with an intimate relationship to the overlying acanthotic epidermis with overlying parakeratosis. [18] In addition to elongation of the rete ridges, the epithelium is usually hyperkeratotic. Thrombosis of the vascular spaces is common, and, frequently, recanalization of occluded vascular spaces occurs, creating the pathologic pattern known as papillary endothelial hyperplasia (Masson lesion). [17]