Diffuse Dermal Angiomatosis: A Clue to the Diagnosis of Atherosclerotic Vascular Disease

Abstract

Diffuse dermal angiomatosis (DDA) is a benign, acquired, reactive vascular proliferation. DDA is clinically characterized by painful purpuric plaque with central ulceration. The histopathologic hallmark is diffuse proliferation of endothelial cells that are arranged interstitially between collagen bundles of the reticular dermis. DDA has been reported in association with peripheral atherosclerotic disease, arteriovenous fistula and heavy smoking. We report the case of a 49-year-old Asian male with DDA who presented with a painful stellate-shaped purpuric patch on the right thigh. Histopathologic examination showed proliferation of CD34-positive spindle cells in the dermis. Our patient underwent vascular bypass surgery along with tight control of cardiovascular risk factors, which yielded successful results.

Diffuse dermal angiomatosis with clinical features simulating calciphylaxis in the setting of end-stage renal disease

“…10 Underlying causes of tissue hypoxia—peripheral vascular disease, atherosclerosis, smoking, and macromastia—should be addressed. 2 , 10 Vascular surgery may be considered to improve arterial blood flow. Well-established guidelines for the management of calciphylaxis are lacking, but the consensus is that a multidisciplinary approach is required.…”

“…Vascular hyperplasia in diffuse dermal angiomatosis results from ischemia or inflammation that upregulates vascular endothelial growth factor. 2 Diffuse dermal angiomatosis can also be observed in the setting of atherosclerosis, which can result in embolization to distant vessels supplying the skin. 3 Clinically, diffuse dermal angiomatosis presents as erythematous, violaceous, and purpuric patches or plaques.…”

Diffuse Dermal Angiomatosis of the Breast: A Distinct Entity in the Spectrum of Cutaneous Reactive Angiomatoses – Clinicopathologic Study of Two Cases and Comprehensive Review of the Literature

“…A wide spectrum of predisposing comorbid conditions have been associated with DDA in other body parts than the breast, such as advanced atherosclerotic vascular disease [ 6 , 7 , 8 , 9 , 10 ], iatrogenic arteriovenous fistula in the setting of chronic hemodialysis [ 11 , 12 ], monoclonal gammopathy [ 13 , 14 ], and the administration of trabectedin and pegfilgrastim in the context of liposarcoma in 1 case [ 15 ]. Cardiovascular risk factors, atherosclerotic vascular disease, and monoclonal gammopathy have also been described in association with DDAB.…”

Cutaneous Disorders of the Breast

“…• Clinical features: It presents at birth with a generalized or nevoid, scaly, erythema without blistering or skin fragility. (Sriphojanart and Vachiramon 2015). In reported cases of breast involvement, the affected patients had large pendulous breasts (Frikha et al 2018;Galambos et al 2017) (Fig.…”