Targetoid hemosiderotic hemangioma

Last updated
Targetoid hemosiderotic hemangioma
Other namesHobnail hemangioma
Specialty Dermatology

Targetoid hemosiderotic hemangioma, also known as a hobnail hemangioma is a skin condition characterized by a central brown or purplish papule that is surrounded by an ecchymotic halo. [1] [2] It may appear similar to melanoma. It was first described by Santa Cruz and Aronberg in 1988. [2]

Contents

Signs and symptoms

Targetoid hemosiderotic hemangioma manifests as a single, tiny, reddish-violaceous to brown targetoid lesion that can grow centrifugally in the acute phase is encircled by a hemorrhagic halo. [3] The halo may vanish in later phases, leaving just a central papule. [4] [5] There have been reports of certain cases without targetoid development. [6] Targetoid hemosiderotic hemangioma typically develops over the trunk and extremities. The majority of these lesions have a diameter of less than 1 cm. [7]

Causes

Although the precise etiology of targetoid hemosiderotic hemangioma is uncertain, trauma has been suggested as one of the primary causes of the targetoid look. [8] [9] Trauma may result in the production of microshunts, wherein the capillary pressure fills the lesion's lymph spaces with erythrocytes, hence promoting the formation of aneurysmal microstructures. [10] There would be interstitial hemosiderin deposits, fibrosis, and inflammation if certain efferent lymphatic veins were blocked. [10] [11] These tumors may potentially be amplified by hormones. [12]

Diagnosis

Red or reddish-blue lakes are clearly visible on dermoscopy, depending on how much of the dermis is involved. [3] Hemorrhagic crusts can also be observed as black macules. [4]

Depending on the developmental stage at which the lesion was biopsied, histology varies. [13] There is a biphasic pattern in the early stages: in the papillary dermis, the vascular spaces are dilated and slit-like, resembling lymphatic vessels, which are concentrated around sweat glands and frequently form small hemangiomatous nodules, dissecting the collagen bundles. In the deep dermis, the vascular spaces are angulated and slit-like, resembling lymphatic vessels, with solid intraluminal projections and a hobnail appearance. [8] [14] There are fibrin thrombi, inflammatory lymphocytic aggregates, and extensive red blood cell extravasation. [5] [8] [14] Later stages show significant hemosiderin deposition in the stroma, fibrosis, and a collapsed appearance of the arterial lumen. [8] [14]

Clinical differential diagnoses include infantile hemangioma, melanocytic lesions, tufted angioma, insect bite, Kaposi sarcoma, erythema multiforme, and dermatofibroma, depending on the stage of evolution. The histological differential diagnoses include epithelioid hemangioma, early Kaposi's sarcoma, progressive lymphangioma, and well-differentiated angiosarcoma. [14] [7]

Treatment

Simple excision is curative and enables for accurate histological diagnosis. These lesions are solely removed for diagnostic or cosmetic purposes because the condition is benign. [3]

See also

Related Research Articles

<span class="mw-page-title-main">Amelanotic melanoma</span> Medical condition

Amelanotic melanoma is a type of skin cancer in which the cells do not make any melanin. They can be pink, red, purple or of normal skin color, and are therefore difficult to diagnose correctly. They can occur anywhere on the body, just as a typical melanoma can.

Lupus erythematosus panniculitis presents with subcutaneous nodules that are commonly firm, sharply defined and nontender.

Anetoderma is a benign but uncommon disorder that causes localized areas of flaccid or herniated sac-like skin due to a focal reduction of dermal elastic tissue. Anetoderma is subclassified as primary anetoderma, secondary anetoderma, iatrogenic anetoderma of prematurity, congenital anetoderma, familial anetoderma, and drug-induced anetoderma.

Palisaded neutrophilic and granulomatous dermatitis (PNGS) is usually associated with a well-defined connective tissue disease, lupus erythematosus or rheumatoid arthritis most commonly, and often presents with eroded or ulcerated symmetrically distributed umbilicated papules or nodules on the elbows.

<span class="mw-page-title-main">Acrokeratoelastoidosis of Costa</span> Medical condition

Acrokeratoelastoidosis of Costa or Acrokeratoelastoidosis is a hereditary form of marginal keratoderma, and can be defined as a palmoplantar keratoderma. It is distinguished by tiny, firm pearly or warty papules on the sides of the hands and, occasionally, the feet. It is less common than the hereditary type of marginal keratoderma, keratoelastoidosis marginalis.

Acquired progressive lymphangioma, also known as benign lymphangioendothelioma is a group of lymphangiomas that occur anywhere in young individuals, grow slowly, and present as bruise-like lesions or erythematous macules. Acquired progressive lymphangioma may develop following radiation therapy, surgery, trauma, inflammation, and tick bites. The treatment of choice is complete surgical excision.

Multifocal lymphangioendotheliomatosis, also known as congenital cutaneovisceral angiomatosis with thrombocytopenia and multifocal lymphangioendotheliomatosis with thrombocytopenia (MLT), is a skin condition that presents at birth with hundreds of red-brown plaques as large as several centimeters.

Microvenular hemangioma is an acquired benign vascular tumor that presents as an asymptomatic, slowly growing, 0.5- to 2.0 cm reddish lesion on the forearms or other sites of young to middle-aged adults. The cause of microvenular hemangioma is unknown, however it has been associated with immunosuppression.

<span class="mw-page-title-main">Angiolymphoid hyperplasia with eosinophilia</span> Medical condition

Angiolymphoid hyperplasia with eosinophilia usually presents with pink to red-brown, dome-shaped, dermal papules or nodules of the head or neck, especially about the ears and on the scalp.

Glomeruloid hemangioma is a distinctive vascular tumor first described in 1990 when found to be associated with POEMS syndrome and Castleman disease. Glomeruloid hemangiomas can manifest as wine-red sessile or pedunculated papules, papulonodules, subcutaneous bluish compressible tumors, or small, firm, reddish-violaceous, dome-shaped papules.

<span class="mw-page-title-main">Cutaneous myxoma</span> Medical condition

A cutaneous myxoma, or superficial angiomyxoma, consists of a multilobulated myxoid mass containing stellate or spindled fibroblasts with pools of mucin forming cleft-like spaces. There is often a proliferation of blood vessels and an inflammatory infiltrate. Staining is positive for vimentin, negative for cytokeratin and desmin, and variable for CD34, Factor VIIIa, SMA, MSA and S-100.

Acral persistent papular mucinosis (APPM) is a rare form of lichen myxedematosus. It is characterized by small papules on the backs of the hands, wrists, and extensor aspects of the distal forearms, with no further clinical or laboratory indications. Lesions tend to persist and may grow in number gradually. Because there are no symptoms, treatment is rarely required.

Onychomatricoma is a cutaneous condition characterized by a distinctive tumor of the nail matrix.

<span class="mw-page-title-main">Generalized granuloma annulare</span> Medical condition

Generalized granuloma annulare is a skin condition of unknown cause, tending to affect women in the fifth and sixth decades, presenting as a diffuse but symmetrical, papular or annular eruption of more than ten skin lesions, and often hundreds.

An Apocrine nevus is an extremely rare cutaneous condition that is composed of hyperplastic mature apocrine glands. Apocrine nevi present as a nodular skin-coloured lump. They are typically asymptomatic. Apocrine nevi can be congenital and they have been associated with other disorders.

<span class="mw-page-title-main">Malignant pilomatricoma</span> Medical condition

Malignant pilomatricoma is a cutaneous condition characterized by a locally aggressive tumor composed of hair-matrix cells.

<span class="mw-page-title-main">Airbag dermatitis</span> Skin irritation caused by airbag deployment

Airbag dermatitis is skin irritation secondary to the deployment of airbags. The diagnosis of "air bag dermatitis" is relatively recent; the first case was reported in 1994.

A superficial acral fibromyxoma is a type of myxoma and is a rare cutaneous condition characterized by a mesenchymal neoplasm that typically occurs on the digits of middle-aged adults.

Rheumatoid neutrophilic dermatitis, also known as rheumatoid neutrophilic dermatosis, is a cutaneous condition associated with rheumatoid arthritis.

Multinucleate cell angiohistiocytoma (MCAH) is a cutaneous condition that presents as slowly growing, multiple, discrete but grouped, red to violaceous papules

References

  1. ↑ DE, Elder; D, Massi; RA, Scolyer; R, Willemze (2018). "Soft tissue tumours: Hobnail hemangioma". WHO Classification of Skin Tumours. Vol. 11 (4th ed.). Lyon (France): World Health Organization. pp. 347–348. ISBN   978-92-832-2440-2.
  2. 1 2 James, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "28. Dermal and subcutaneous tumors". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Edinburgh: Elsevier. p. 594. ISBN   978-0-323-54753-6.
  3. 1 2 3 Kakizaki, Priscila; Valente, Neusa Yuriko Sakai; Paiva, Daniele Loureiro Mangueira; Dantas, Fernando Luiz Teixeira; Gonçalves, Sheila Viana Castelo Branco (2014). "Targetoid hemosiderotic hemangioma - Case report". Anais Brasileiros de Dermatologia. 89 (6). FapUNIFESP (SciELO): 956–959. doi:10.1590/abd1806-4841.20143264. ISSN   0365-0596.
  4. 1 2 Sahin, M. T.; Demir, M. A.; Gunduz, K.; Ozturkcan, S.; Turel-Ermertcan, A. (2005). "Targetoid haemosiderotic haemangioma: dermoscopic monitoring of three cases and review of the literature". Clinical and Experimental Dermatology. 30 (6). Oxford University Press (OUP): 672–676. doi:10.1111/j.1365-2230.2005.01924.x. ISSN   0307-6938. PMID   16197386.
  5. 1 2 Al Dhaybi, Rola; Lam, Christina; Hatami, Afshin; Powell, Julie; McCuaig, Catherine; Kokta, Victor (2012). "Targetoid hemosiderotic hemangiomas (hobnail hemangiomas) are vascular lymphatic malformations: A study of 12 pediatric cases". Journal of the American Academy of Dermatology. 66 (1). Elsevier BV: 116–120. doi:10.1016/j.jaad.2011.05.025. ISSN   0190-9622. PMID   21798621.
  6. ↑ Carlson, J.Andrew; Daulat, Soume; Goodheart, Herbert P. (1999). "Targetoid hemosiderotic hemangioma— a dynamic vascular tumor: Report of 3 cases with episodic and cyclic changes and comparison with solitary angiokeratomas". Journal of the American Academy of Dermatology. 41 (2). Elsevier BV: 215–224. doi:10.1016/s0190-9622(99)70052-6. ISSN   0190-9622. PMID   10426892.
  7. 1 2 Gutte, RameshwarM; Joshi, Abhijit (2014). "Targetoid hemosiderotic hemangioma". Indian Dermatology Online Journal. 5 (4). Medknow: 559–560. doi: 10.4103/2229-5178.142579 . ISSN   2229-5178. PMC   4228682 . PMID   25396170.
  8. 1 2 3 4 Santa Cruz, Daniel J.; Aronberg, Jerome (1988). "Targetoid hemosiderotic hemangioma". Journal of the American Academy of Dermatology. 19 (3). Elsevier BV: 550–558. doi:10.1016/s0190-9622(88)70211-x. ISSN   0190-9622.
  9. ↑ Christenson, Leslie J.; Stone, Mary Seabury (2001). "Trauma-Induced Simulator of Targetoid Hemosiderotic Hemangioma". The American Journal of Dermatopathology. 23 (3). Ovid Technologies (Wolters Kluwer Health): 221–223. doi:10.1097/00000372-200106000-00010. ISSN   0193-1091. PMID   11391103.
  10. 1 2 Franke, Folker E.; Steger, Klaus; Marks, Alexander; Kutzner, Heinz; Mentzel, Thomas (2004). "Hobnail hemangiomas (targetoid hemosiderotic hemangiomas) are true lymphangiomas". Journal of Cutaneous Pathology. 31 (5): 362–367. doi:10.1111/j.0303-6987.2004.00192.x. ISSN   0303-6987. PMID   15059220.
  11. ↑ Trindade, Felicidade; Kutzner, Heinz; Tellechea, Óscar; Requena, Luis; Colmenero, Isabel (2012). "Hobnail hemangioma reclassified as superficial lymphatic malformation: A study of 52 cases". Journal of the American Academy of Dermatology. 66 (1). Elsevier BV: 112–115. doi:10.1016/j.jaad.2011.05.019. ISSN   0190-9622. PMID   21821311.
  12. ↑ Ortiz-Rey, JA; González-Ruiz, A; Miguel, P San; Álvarez, C; Iglesias, B; Antón, I (2005-03-31). "Hobnail haemangioma associated with the menstrual cycle". Journal of the European Academy of Dermatology and Venereology. 19 (3). Wiley: 367–369. doi:10.1111/j.1468-3083.2004.01168.x. ISSN   0926-9959. PMID   15857469.
  13. ↑ Guillou, Louis; Calonje, Eduardo; Speight, Paul; Rosai, Juan; Fletcher, Christopher D.M. (1999). "Hobnail Hemangioma". The American Journal of Surgical Pathology. 23 (1). Ovid Technologies (Wolters Kluwer Health): 97–105. doi:10.1097/00000478-199901000-00011. ISSN   0147-5185.
  14. 1 2 3 4 Mentzel, Thomas; Partanen, Taina A.; Kutzner, Heinz (1999). "Hobnail hemangioma ("targetoid hemosiderotic hemangioma"): clinicopathologic and immunohistochemical analysis of 62 cases". Journal of Cutaneous Pathology. 26 (6). Wiley: 279–286. doi:10.1111/j.1600-0560.1999.tb01845.x. ISSN   0303-6987. PMID   10472756.

Further reading

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.