Excision and a Pulsed Dye Laser for Cutaneous Angiokeratoma

Abstract and Introduction

Abstract

Background: Angiokeratomas are vascular neoplasms with hyperkeratotic red to black papules and plaques, which may present as solitary or multiple lesions with variations in color, shape, and location. Successful treatment not only involves improvement of these symptoms but also cosmetic improvement. This report reviews 2 cases of cutaneous angiokeratoma treated with surgical excision and a 595-nm pulsed dye laser (PDL) in which the patients showed improvement of symptoms and cosmetic appearance. There are various types of angiokeratomas, and their extent, size, condition, and symptoms are different. Therefore, lesion-specific combined treatments may yield better results.

Introduction

Angiokeratomas are vascular neoplasms with hyperkeratotic red to black papules and plaques, which may present as solitary or multiple lesions with variations in color, shape, and location.

Angiokeratomas are clinically classified as follows: widespread forms (angiokeratoma corporis diffusum) and localized forms [solitary angiokeratoma, angiokeratoma of Mibelli, angiokeratoma scroti (angiokeratoma of Fordyce), and angiokeratoma circumscriptum naeviforme].^[1] The color tone, size, ridge, and localization of lesions differ depending on the type and case. Angiokeratomas, though often asymptomatic, may present with symptoms such as bleeding, itching, and a cosmetic psychological burden.^[1] Treatment should target both cosmetic and symptom improvement. Treatments such as surgical excision, electrical stimulation, ablation, cryotherapy, and laser treatment have been reported, but angiokeratomas can be difficult to treat due to the necessity of appropriate treatment depending on the clinical condition of the lesion, especially in cases of extensive lesions and protuberance. This report describes 2 cases of angiokeratoma treated with surgical excision and a 595-nm pulsed dye laser (PDL).