PMC9052825_01
Patient #1: (a) extensive ill-defined right breast violaceous patch; (b)
on dermoscopy using 10x polarized light, a regular pattern of parallel
linear wavy/sinusoidal vessels was seen; (c) in addition to
hyperpigmented macules, skin thickening with flexion contracture at the
distal interphalangeal level was seen; (d) a plasmocytoma was found in
the intercostal space on computed tomography.
10.1177_2050313X221091602-fig1.jpg
PMC9052825_01_10.1177_2050313X221091602-fig1.jpg
fig1-2050313X221091602
A 63-year-old female presented with a tender right thoracic violaceous patch that had appeared 1.5 years ago (Figure 1(a)); dermoscopic evaluation showed regular branching linear vessels suggestive of benign vascular lesion reminiscing of a telangiectasia (Figure 1(b)). Additional features of physical examination at that time revealed facial lipoatrophy, diffuse hyperpigmentation of the upper and lower limbs, and sclerodermoid changes on her hands (Figure 1(c)). A computerized tomography (CT) scan of the chest wall revealed an osteolytic lesion on the seventh right rib (Figure 1(d)), histology of which was consistent with a plasmacytoma.
Patient #2: (a) ill-defined large erythemato-violaceous patch in the
right clavicular area. The histopathologic features of this and two
other cases demonstrated a regular proliferation of small blood vessels
with a 90  branching (arrow) without any nuclear atypia or
pleiomorphism; (b) stain for human herpes virus 8 was negative. CD34
stain was positive (close-up).
10.1177_2050313X221091602-fig2.jpg
PMC9052825_02_10.1177_2050313X221091602-fig2.jpg
fig2-2050313X221091602
He also complained of a new violaceous patch on his right upper chest (Figure 2(a)). Skin biopsy of the violaceous patch was identical to the first case (benign vascular proliferation, HHV8-, CD34+) (Figure 2(b)).
PMC9052825_02
Patient #2: (a) ill-defined large erythemato-violaceous patch in the
right clavicular area. The histopathologic features of this and two
other cases demonstrated a regular proliferation of small blood vessels
with a 90  branching (arrow) without any nuclear atypia or
pleiomorphism; (b) stain for human herpes virus 8 was negative. CD34
stain was positive (close-up).
10.1177_2050313X221091602-fig2.jpg
PMC9052825_02_10.1177_2050313X221091602-fig2.jpg
fig2-2050313X221091602
He also complained of a new violaceous patch on his right upper chest (Figure 2(a)). Skin biopsy of the violaceous patch was identical to the first case (benign vascular proliferation, HHV8-, CD34+) (Figure 2(b)).
PMC9052825_03
Patient #3: (a) extensive oval shaped violaceous patch extends from the
chest to abdomen area; (b) small 2-4 mm red-violaceous papules can be
seen on the right of the patch, similar lesions scattered on the trunk,
limbs, and face; (c) dermoscopy using a 10x magnification showing red
lacunae similar to those seen in cherry angioma; (d) biopsy of one of
these papules demonstrates numerous ectatic vascular spaces, some
resembling renal glomeruli and thereby confirming the suspicion of
glomeruloid hemangiomas.
10.1177_2050313X221091602-fig3.jpg
PMC9052825_03_10.1177_2050313X221091602-fig3.jpg
fig3-2050313X221091602
A 64-year-old man presented with a 12 cm x 17 cm abdominal violaceous patch (Figure 3(a)), weight loss and lower limb weakness. Other cutaneous features included diffuse hyperpigmentation, hypertrichosis, facial lipoatrophy, and small scattered violaceous papules on trunk (Figures 3(b)). While the dermoscopic features of these papules were indistinguishable from cherry angiomas, histopathogic examination confirmed glomeruloid hemangiomas (Figure 3(c) and (d)).