Hobnail hemangioma: a immunohistochemical study and literature review

Hobnail hemangioma of the skin in a juvenile patient

“…Based on immunohistochemical reaction with endothelial cells markers, some authors suggest a lymphatic origin of HH [2] and propose the term 'superficial lymphatic malformation' [3] or 'superficial hemosyderotic lymphovascular malformation' [8] as more appropriate for this entity. Unlike the present study, in many reports HHs were positive for both lymphatic (D2-40), and vascular (CD34) endothelial cell markers that may indicate biphasic nature of the lesions [5,11]. A neoplastic nature of HH is also doubtful.…”

“…Vessels are lined by plump, exophytic endothelial cells showing a hobnail appearance. In some cases, the endothelial cells are hobnail-like in the superficial part of the lesion, but in the deeper part they are flat and inconspicuous [5]. Hemosiderin deposits, extravasated erythrocytes and mononuclear inflammatory infiltrate are also observed [3,5,11].…”

“…In some cases, the endothelial cells are hobnail-like in the superficial part of the lesion, but in the deeper part they are flat and inconspicuous [5]. Hemosiderin deposits, extravasated erythrocytes and mononuclear inflammatory infiltrate are also observed [3,5,11]. Due to their gross and microscopic features, HHs have to be differentiated from variety of pathological lesions including other vascular tumors and malformations, especially cherry angioma, angiokeratoma, haemangioma in pregnancy, low grade angiosarcoma and Kaposi sarcoma, as well as melanocytic naevi, melanoma, dermatofibroma, seborrhoeic keratosis, and pigmented basal cell carcinoma.…”

“…HH affects mainly young and middle-aged adults with a slightly male predominance [3]. The most common localization is the skin of the extremities and trunk, but unusual sites like the oral and nasal mucosa have been also reported [4,5]. Trauma of the normal skin or pre-existing hemangioma is regarded as a predisposing factor, but sex hormones may also influence the morphology, resulting in the cyclic changes of diameter and peripheral colour [6].…”

Hobnail Hemangioma (Superficial Hemosiderotic Lymphovascular Malformation) in Children

“…3 Acquired SHLM has been reported in ages ranging from age 10 months to 82 years. 7,8 In adults, it is most commonly seen between the second to fourth decades of life, while in children the mean age is around 11 years. 3,9 The incidence appears to be approximately equal in males and females.…”