This is a rare disease which usually occurs in
children. It is often preceded by chilblains and consists of red points that
proliferate to form vascular growths of pinhead size, the surfaces of which in
the course of time become hyperkeratotic. The lesions are dull red or purplish
black, rounded papules that may be verrucous and wartlike. They may be single
or multiple, and in the latter instance are usually closely grouped. Bleeding may cause the patient to seek medical advice. The dorsal
aspects of the fingers and toes, and the elbows and knees, are sites of
predilection. The patient often suffers from cold, cyanotic hands and feet. A
history of exposure to cold, of frostbite or pernio often is obtained.
Way has described the histology which shows
signs of injury to the blood vessels with hypertrophy of the stratum corneum,
increase of the granular layer and dilatation of the subpapillary vessels into
lacunae. The vascular or lacunar spaces frequently are not lined with
endothelium, and the epidermis usually forms part of the wall of the vascular
space.
Treatment.
Angiokeratoma may be treated by the cautery point, electrolysis, or
electrodesiccation, or refrigeration with solid carbon dioxide. There is little
choice between these methods.