JCDSA  Vol.1 No.4 , December 2011
Verrucous Hemangioma Mimicking Melanoma in an Elderly Man
Verrucous hemangioma (VH) is an uncommon, congenital, vascular anomaly that resembles angiokeratoma but it encompasses distinctive clinicopathological features. The differential diagnosis of this entity included all the hyperkeratotic vascular tumors and malformations and, especially in localized cases, pigmented lesions. VH lesions initially present at birth, and therefore, the diagnosis in the elderly may be difficult. We present a 77 year-old patient with a birth lesion on the back of his calf who came to the clinic with a two year history of enlargement of this lesion following trauma. We performed an excisional biopsy because clinical appearance simulated melanoma arising from a congenital nevus. Nevertheless, the histopathological examination revealed a verrucous hemangioma. A diagnosis of VH should be considered in erythematous papules, nodules, and plaques, especially those that are hyperkeratotic, present at birth, located on the lower extremities, and show growth after trauma or infection.

Cite this paper
nullL. Pérez-Varela, J. Del Pozo, F. Pineyro, F. Sacristán, C. Peña, B. Fernández-Jorge, R. Rodríguez-Lojo and A. Wong, "Verrucous Hemangioma Mimicking Melanoma in an Elderly Man," Journal of Cosmetics, Dermatological Sciences and Applications, Vol. 1 No. 4, 2011, pp. 153-156. doi: 10.4236/jcdsa.2011.14023.

[1]   L. B. Tennant, J. B. Mulliken, A. R. Perez-Atayde and H. P. Kozakewich, “Verrucous Hemangioma Revisited,” Pediatric Dermatology, Vol. 23, No. 3, 2006, pp. 208-215. doi:10.1111/j.1525-1470.2006.00219.x

[2]   A. Brown, S. Warren, H. W. Losken and D. S. Morrell, “Verrucous Lymphovascular Malformation versus Verrucous Hemangioma: Controversial Nomenclature,” Cutis, Vol. 81, No. 5, 2008, pp. 390-396.

[3]   R. Al Dhaybi, J. Powell, C. McCuaig and V. Kokta, “Differentiation of Vascular Tumors from Vascular Malformations by Expression of Wilms Tumor 1 Gene: Evaluation of 126 Cases,” Journal of the American Academy of Dermatology, Vol. 63, No. 6, 2010, pp. 1052-1057. doi:10.1016/j.jaad.2009.12.017

[4]   R. Imperial and E. B. Helwig, “Verrucous Hemangioma. A Clinicopathologic Study of 21 Cases,” Archives of Dermatology, Vol. 96, No. 3, 1967, pp. 247-253. doi:10.1001/archderm.1967.01610030025004

[5]   M. H. Mankani and C. R. Dufresne, “Verrucous Malformations: Their Presentation and Management,” Annals of Plastic Surgery, Vol. 45, No. 1, 2000, pp. 31-36. doi:10.1097/00000637-200045010-00006

[6]   I. Lara-Corrales, G. R. Somers and N. Ho, “Verrucous Hemangioma: A Challenging Vascular Lesion,” Journal of Cutaneous Medicine and Surgery, Vol. 14, No. 3, 2010, pp. 144-146.

[7]   L. Calduch, C. Ortega, V. Navarro, E. Martínez, I. Molina, and E. Jordá, “Verrucous Hemangioma: Report of Two Cases and Review of the Literature,” Pediatric Dermatology, Vol. 17, No. 3, 2000, pp. 213-217. doi:10.1046/j.1525-1470.2000.01755.x

[8]   M. Koc, M. Kavala, E. Kocatürk, E. Zemheri, I. Zindanci, S. Sudogan and E. Kural, “An Unusual Vascular Tumor: Verrucous Hemangioma,” Dermatology Online Journal, Vol. 15, No. 11, 2009, p. 7.

[9]   V. K. Jain, K. Aggarwal and S. Jain, “Linear Verrucous Hemangioma on the Leg,” Indian Journal of Dermatology, Venereology and Leprology, Vol. 74, No. 6, 2008, pp. 656-658. doi:10.4103/0378-6323.45119

[10]   R. Loria, J. Derbes and J. D. Kerafchuck, “Keratotic Hemangiomas,” Archives of Dermatology , Vol. 74, 1956, pp. 437-438.

[11]   L. Goldman, S. H. Gibson and D. F. Richfield, “Thrombotic Angiokeratoma Circumscriptum Simulating Melanoma,” Archives of Dermatology, Vol. 117, No. 3, 1981, pp. 138-139. doi:10.1001/archderm.1981.01650030016009

[12]   F. De Dulanto, M. A. Moreno, F. C. Martinez and R. N. Sintes, “Solitary Black Angiokeratoma and Verrucous Hemangioma. Problems and Transcendency of Differential Diagnosis with Malignant Melanoma. Treatment,” Actas Dermosifiliogr, Vol. 66, No. 7-8, 1975, pp. 367-386.

[13]   P. I. Schiller and P. H. Itin, “Angiokeratomas: An Update,” Dermatology, Vol. 193, No. 4, 1996, pp. 275-282. doi:10.1159/000246270

[14]   A. Rossi, M. Bozzi and E. Barra, “Verrucous Hemangioma and Angiokeratoma Circumscriptum: Clinical and Histological Differential Characteristics,” Journal of Der- matologic Surgery & Oncology, Vol. 15, No. 1, 1989, pp. 88-91.

[15]   J. Del Pozo and E. Fonseca, “Angiokeratoma Circumscriptum Naeviforme: Succesfull Treatment with Carbon Dioxide Laser Vaporization,” Dermatologic Surgery, Vol. 31, No. 2, 2005, pp. 232-236. doi:10.1111/j.1524-4725.2005.31048

[16]   M. T. Sahin, A. Türel-Ermertcan, S. Oztürkcan and P. Türkdogan, “Thrombosed Solitary Angiokeratoma of Mibelli Simulating Malignant Melanoma: The Importance of Dermoscopy in Differential Diagnosis,” Journal of the European Academy of Dermatology and Venereology, Vol. 20, No. 1, 2006, pp. 102-104. doi:10.1111/j.1468-3083.2005.01299.x