In 1988, Ramsay et al proposed an entity of acral pseudolymphomatous angiok
eratoma of children (with an abbreviation of APACHE) for the unilateral mul
tiple angiomatous papules affecting the acral region of the extremities of
children. We report here similar lesions that developed in the acral portio
ns of 1 female adolescent and 2 women. Histopathologically, they showed pse
udolymphomatous features rather than those of angiokeratoma. Thus, the term
should be acral angiokeratoma-like pseudolymphoma would be more appropriat
e than APACHE originally proposed.