An otherwise healthy man in his early 70s presented to the Department of Dermatology with a 2-year history of a mildly pruritic, erythematous, and gradually enlarging lesion on the proximal portion of his left calf. The lesion had appeared without an identifiable cause, and for the previous 2 months, the patient had applied topical corticosteroids and antifungals with no improvement. Physical examination revealed an ill-defined, nonindurated, erythematous-violaceous plaque that was slightly raised but with an atrophic appearance (Figure, A). A skin biopsy was obtained for histopathology examination (Figure, B-D).
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A. Poikilodermatous plaque–like hemangioma
Histopathologic evaluation showed a band-like vascular proliferation in the upper dermis with no grenz zone. Vascular spaces were round and lined by a single layer of endothelial cells. No hemosiderin deposits were found with Perls Prussian blue stain. Vascular channel endothelial cells were positive for CD34 and CD31 but negative for D2-40. Based on histopathological findings, a diagnosis of poikilodermatous plaque–like hemangioma (PPH) was established. Considering the benign nature of the lesion, no treatment was performed.
Poikilodermatous plaque–like hemangioma is a newly described vascular proliferation. To our knowledge, only 17 cases of PPH have been reported. It is typically located on the lower extremity of older adult men and commonly described as a slowly growing, asymptomatic, solitary, erythematous-violaceous plaque with an overlying cigarette-paper wrinkling that gives an atrophic appearance.1,2
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Corresponding Author: Dídac Marín-Piñero, MD, Department of Dermatology, Hospital Universitari Sagrat Cor, Grupo Quirónsalud, C/Viladomat, 288, 08029 Barcelona, Spain (email@example.com).
Published Online: June 29, 2022. doi:10.1001/jamadermatol.2022.2492
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient for granting permission to publish this information.
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