PMC10224690_01
(A-C) Scattered dark purple peanut to thumb-sized nodules, ulcers, purulent discharge, bruising, and varicose veins in both lower extremities.
CCID-16-1319-g0001.jpg
PMC10224690_01_CCID-16-1319-g0001.jpg
f0001
Furthermore, there was sunken edema in both calves and feet, which was more apparent in the right calf (as shown in Figure 1A-C). 
(A) Tumor masses growing inward and outward were seen in the mid dermis of the section; the epidermis above was missing and covered with pus and blood crust, and the epidermis on both sides was extended in a collar shape (HE, 40x). (B) A dense, narrow mature vascular lumen formation was seen in the dermis, containing erythrocytes, spaced with loose collagen tissue, plexiform vascular endothelial cell growth was seen, and formed lumen, no cellular anisotropy, and erythrocyte spillage (black arrows) was seen (HE, 200x).
CCID-16-1319-g0002.jpg
PMC10224690_01_CCID-16-1319-g0002.jpg
f0002
There was no cellular anisotropy or erythrocyte spillage observed (as shown in Figure 2A and B).
PMC10224690_02
Immunohistochemistry (A) HHV-8(-), (magnification,x100). (B) Ki-67(+) (black arrows), (magnification,x100). (C) Vascular endothelial cells CD34(+) (black arrows), mesenchymal cells CD34(-) (magnification,x200). (D) Fli-1(+) (blackarrows), (magnification,x100). (E) VEGF(+) (black arrows), (magnification,x100).
CCID-16-1319-g0003.jpg
PMC10224690_02_CCID-16-1319-g0003.jpg
f0003
Fli-1 was positive, HHV-8 was negative, Ki-67 was about 20%, and VEGF was positive (as shown in Figure 3A-E).
PMC10224690_03