ACROANGIODERMATITIS - A STUDY OF 10 CASES

Background. Acroangiodermatitis is a benign vesicular process encounte red on the lower extremities that histologically resembles the superfi cial form of stasis dermatitis, but is clinically characterized by cir cumscribed violaceous, brown or dusky macules, papules, or plaques. Fu rthermore, unlike stasis dermatitis, acroangiodermatitis is usually as sociated with minimal epidermal changes and eosinophils in the inflamm atory infiltrate in the dermis. Kaposi's sarcoma, pigmented purpura, v asculitis, and lichen planus are other conditions that should be consi dered when making a diagnosis of acroangiodermatitis. Methods. Ten pat ients with acroangiodermatitis were referred to us by area physicians. Hematoxylin and eosin, periodic acid-Schiff, Pearl's (an iron stain), and an immunoperoxidase stain for Factor VIII were performed on routi nely embedded paraffin sections. Results. All cases showed new vessel proliferation, perivascular inflammation of superficial and mid-dermis , consisting of lymphocytes, histiocytes, eosinophils, occasional plas ma cells, extravasation of red blood cells, and hemosiderin pigment de position. Dermal fibrosis was observed in all cases. None of the patie nts showed changes of vasculitis or Kaposi's sarcoma. Only one patient displayed significant epidermal changes of spongiosis and mild acanth osis. Conclusions. Acroangiodermatitis is an uncommon entity with pecu liar clinical and histologic features and should be confirmed by histo logic tests.