Cases in Diagnosis
Not All Is Infantile Hemangioma: An Erythematous Plaque in an Adult
Placa eritematosa en un adulto: no todo es hemangioma infantil
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"apellidos" => "Salgüero Fernández" "email" => array:1 [ 0 => "irenebsf@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Hospital Gil" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "L." "apellidos" => "Nájera Botello" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "G." "apellidos" => "Roustan Gullón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Puerta deHierro, Majadahonda, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Placa eritematosa en un adulto: no todo es hemangioma infantil" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 604 "Ancho" => 900 "Tamanyo" => 82023 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical image showing an atrophic-looking, erythematous, violaceous plaque on the thigh.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Case Description</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 66-year-old man was seen in March 2020 for a slow-growing asymptomatic lesion on the right leg that had appeared several years earlier. Physical examination revealed a shiny, erythematous, violaceous plaque with poorly defined borders, and the absence of other similar lesions elsewhere on the body (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The patient did not recall any prior bite or trauma in the affected area. He had a history of high blood pressure, for which he had been treated for several years with manidipine and losartan/hydrochlorothiazide, and was in dermatological follow-up for chronic actinic damage, for which he had been undergoing photodynamic therapy since 2016.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">A biopsy was performed based on a suspected diagnosis of mycosis fungoides. Histology showed hyperkeratosis of the epidermis with irregular hyperplasia and edema, proliferation of small caliber vessels, and discreet fibrosis in the dermis. No evidence of malignancy was observed in the examined sample. Immunohistochemistry confirmed that the vessels within the lesion were positive for CD31 and small muscle actin (SMA), and negative for D2-40 and Perls blue (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">What is your Diagnosis?</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Diagnosis</span><p id="par0020" class="elsevierStylePara elsevierViewall">Poikilodermatous plaque-like hemangioma.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Clinical Course and Comment</span><p id="par0025" class="elsevierStylePara elsevierViewall">Based on the clinical and pathological findings it was possible to establish a diagnosis of poikilodermatous plaque-like hemangioma, for which the patient began treatment with clobetasol propionate and pimecrolimus on alternate days for 2 months. No improvement was observed, and treatment was consequently discontinued.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Poikilodermatous plaque-like hemangioma is an entity recently described in a series of 16 patients by Semkova et al.,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> and subsequently in an additional case report.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> This lesion occurs more frequently in males aged 50 years and above, manifesting as a single erythematous or violaceous plaque, generally located on the lower extremities, as in the present case. Follow-up of cases described to date (maximum follow-up duration, 6 y) indicates a benign course (i.e. stable, without malignant transformation). However, given that this is a recently described pathology, it is advisable to be attentive to any changes or progression.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Histology of this lesion is characteristic, revealing a band-like pattern of proliferating thin-walled vessels with features of postcapillary veins in the superficial dermis. Changes such as hyperplasia and spongiosis can be observed in the epidermis. Strikingly, epidermal atrophy is absent, despite the clinical appearance of the lesions. Fibrotic changes in the dermis are occasionally described.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The main differential diagnosis is solitary plaque mycosis fungoides,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> owing to the clinical presentation and location of the lesions. In contrast to plaque mycosis fungoides, this lesion features a more reddish–violet coloration and thin atrophic skin without scaling, findings that can help orient the diagnosis. Other conditions to be considered in the differential diagnosis include fixed drug eruption, chronic atrophic acrodermatitis, chronic pigmentary purpura, and acquired elastotic hemangioma (D2-40<span class="elsevierStyleSup">+</span>).</p><p id="par0045" class="elsevierStylePara elsevierViewall">While the etiology is unknown, authors who have described this entity have highlighted a cluster of cases in northern England, suggesting a potential common external or infectious agent. Our patient reported no recent trips to England.</p><p id="par0050" class="elsevierStylePara elsevierViewall">It should be noted that for the diagnosis of vascular anomalies most dermatologists rely on the International Society for the Study of Vascular Anomalies (ISSVA) classification,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> which was most recently updated in 2018 but does not include all entities seen by dermatologists on a daily basis, such as lobular capillary hemangiomas, intramuscular hemangiomas,<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> or poikilodermatous plaque-like hemangioma.</p><p id="par0055" class="elsevierStylePara elsevierViewall">In conclusion, we describe a case of poikilodermatous plaque-like hemangioma, a condition we believe should be considered in patients with corresponding clinical signs.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conflicts of Interest</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Case Description" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Diagnosis" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Clinical Course and Comment" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflicts of Interest" ] 4 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 604 "Ancho" => 900 "Tamanyo" => 82023 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical image showing an atrophic-looking, erythematous, violaceous plaque on the thigh.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 753 "Ancho" => 1508 "Tamanyo" => 323113 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Histological images showing hyperkeratosis and irregular hyperplasia of the epidermis and blood vessel proliferation in a band-like pattern in the superficial dermis. A–C, Hematoxylin eosin, panoramic view (A), original magnification ×20 (B), original magnification ×40 (c). D, CD31. E, Small muscle actin. F, D2-40. G, Perls blue.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Poikilodermatous plaque-like hemangioma: case series of a newly defined entity" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Semkova" 1 => "R. Carr" 2 => "M. Grainger" 3 => "R. Green" 4 => "A. Hafejee" 5 => "A. Makrygeorgou" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2019.03.069" "Revista" => array:7 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2019" "volumen" => "81" "paginaInicial" => "1257" "paginaFinal" => "1270" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30930084" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1550728920302409" "estado" => "S300" "issn" => "15507289" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Poikilodermatous plaque-like hemangioma – a benign vasoformative entity with reproducible histopathologic and clinical features [published online ahead of print, 2020 May 3]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Sullivan" 1 => "R. Hartman" 2 => "M. Mahalingam" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "J Cutan Pathol" "fecha" => "2020" "paginaInicial" => "10" "itemHostRev" => array:3 [ "pii" => "S1550728918305124" "estado" => "S300" "issn" => "15507289" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Poikilodermatous mycosis fungoides: a study of its clinicopathological, immunophenotypic, and prognostic features" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R.A. Abbott" 1 => "D. Sahni" 2 => "A. Robson" 3 => "N. Agar" 4 => "S. Whittaker" 5 => "J.J. Scarisbrick" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2010.05.041" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2011" "volumen" => "65" "paginaInicial" => "313" "paginaFinal" => "319" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21529998" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vascular Anomalies (Part I): Classification and Diagnostics of Vascular Anomalies Gefäßanomalien (Teil I): Klassifikation und Diagnostik von Gefäßanomalien" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Sadick" 1 => "R. Müller-Wille" 2 => "M. Wildgruber" 3 => "W.A. Wohlgemuth" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/a-0620-8925" "Revista" => array:6 [ "tituloSerie" => "Rofo" "fecha" => "2018" "volumen" => "190" "paginaInicial" => "825" "paginaFinal" => "835" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29874693" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Oral intramuscular hemangioma: report of three cases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.M. Lescura" 1 => "B.A.B. de Andrade" 2 => "K.T. Bezerra" 3 => "M. Agostini" 4 => "M.V.A. Ankha" 5 => "F. de Castro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/cup.13482" "Revista" => array:7 [ "tituloSerie" => "J Cutan Pathol" "fecha" => "2019" "volumen" => "46" "paginaInicial" => "603" "paginaFinal" => "608" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31006896" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1550728921001398" "estado" => "S300" "issn" => "15507289" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00017310/0000011300000007/v1_202207140532/S0001731022004732/v1_202207140532/en/main.assets" "Apartado" => array:4 [ "identificador" => "6149" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Casos para el diagnóstico" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011300000007/v1_202207140532/S0001731022004732/v1_202207140532/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731022004732?idApp=UINPBA000044" ]
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|---|---|---|---|
| 2024 November | 16 | 11 | 27 |
| 2024 October | 121 | 56 | 177 |
| 2024 September | 121 | 37 | 158 |
| 2024 August | 147 | 74 | 221 |
| 2024 July | 99 | 43 | 142 |
| 2024 June | 112 | 41 | 153 |
| 2024 May | 98 | 43 | 141 |
| 2024 April | 98 | 40 | 138 |
| 2024 March | 84 | 32 | 116 |
| 2024 February | 57 | 34 | 91 |
| 2024 January | 49 | 43 | 92 |
| 2023 December | 62 | 32 | 94 |
| 2023 November | 77 | 31 | 108 |
| 2023 October | 62 | 39 | 101 |
| 2023 September | 44 | 30 | 74 |
| 2023 August | 48 | 13 | 61 |
| 2023 July | 66 | 37 | 103 |
| 2023 June | 63 | 21 | 84 |
| 2023 May | 59 | 27 | 86 |
| 2023 April | 35 | 27 | 62 |
| 2023 March | 59 | 32 | 91 |
| 2023 February | 51 | 37 | 88 |
| 2023 January | 61 | 63 | 124 |
| 2022 December | 65 | 61 | 126 |
| 2022 November | 65 | 42 | 107 |
| 2022 October | 66 | 46 | 112 |
| 2022 September | 62 | 51 | 113 |
| 2022 August | 97 | 70 | 167 |
| 2022 July | 155 | 74 | 229 |
| 2022 June | 38 | 74 | 112 |
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