Derm

Angiokeratoma

Angiokeratoma, Angiokeratoma of the Glans Penis, Fabry Disease, Angiokeratoma of Fordyce, Angiokeratoma of Mibelli, Angiokeratoma circumscriptum

Sporadic onset in most cases
1. Differentiate from Fabry Disease, which is X-Linked
Enoxaparin
1. Rare adverse effect

Characteristics
1. Red-blue to black, benign vascular Papules
2. Typically 1-2 mm in size (up to 6 mm)
Dermoscopy
1. Dark lacunae
2. White veil
3. Keratinization
4. Henmorrhagic cysts
Distribution: Clustered Genitourinary Lesions (Angiokeratoma of Fordyce)
1. Clustered on the glans penis (or Vulva in women), often linear along the margin
2. May occur on Scrotum, groin, thighs, and abdominal wall
Solitary Angiokeratoma
1. Single, isolated benign lesions that typically require no treatment
Distribution: Palms and Soles in Children (Angiokeratoma of Mibelli)
1. Multiple acral (palms/soles) verrucous (warty) Angiokeratomas in children
Distribution: Leg lesions in newborns (Angiokeratoma circumscriptum)
1. Congenital clustered lesions present at birth, typically on the lower extremities
Red Flag: Lesions on the penile shaft, suprapubic region or Sacrum
1. Suggests Fabry Disease and requires referral (see below)

Pearly Penile Papules
Penile Cancer
Fabry Disease (Lysosomal Storage Disease)
1. Presents with multipls Angiokeratomas on the penile shaft, suprapubic region, thighs, buttocks or Sacrum (bathing suit distribution)
2. Fabry Disease is associated with Renal Failure, Cardiomyopathy, Hypertension, Anhidrosis and neuropathic pain
3. Requires urgent Consultation