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Acroangiodermatitis (pseudo-Kaposi sarcoma): three case reports.Acta
Dermatovenerol Croat. 2007;15(3):152-7.
Acroangiodermatitis (synonym pseudo-Kaposi sarcoma) is a
dermatological condition characterized by purple-colored nodules,
plaques or patches, mostly on the extensor surfaces of lower
extremities, usually in patients with chronic venous insufficiency
and arteriovenous malformations of the legs, but also in
hemodialysis patients with iatrogenic arteriovenous shunts,
paralyzed limbs and amputation stumps. Acroangiodermatitis in
patients with chronic venous insufficiency manifests usually as
bilateral skin lesions located on the dorsa of the feet, halux and
second toe, or on the medial aspect of lower legs.
Acroangiodermatitis may look like Kaposi sarcoma, but in contrast
to Kaposi sarcoma, acroangiodermatitis is not characterized by
progression of changes, and there is a lack of spindle cells and
silt-like vessels on histopathologic analysis. Three cases of
acroangiodermatitis encountered in our clinical practice are
described. The patients presented with livid-erythematous patches
on lower legs and skin changes connected with chronic venous
insufficiency, treated at the Department Phlebology Unit. Results
of the histopathologic analysis indicated acroangiodermatitis.
Thus, in clinical practice it is important to recognize
acroangiodermatitis and to exclude Kaposi sarcoma, as sometimes
there is similarity with this entity. Topical therapy with neutral
and local corticosteroid preparations is often useful, however,
the use of compressive bandages and dermatologic follow up are
recommended.
Expression of
the CD34 antigen distinguishes Kaposi's sarcoma from
pseudo-Kaposi's sarcoma (acroangiodermatitis).Br
J Dermatol. 1996 Jan;134(1):44-6.
The
differential diagnosis between Kaposi's sarcoma and the so-called
'pseudo-Kaposi's sarcoma' or acroangiodermatitis of the feet is
often fraught with difficulty, not only on clinical but also on
histological grounds. The aim of this study was to assess whether
immunolabelling for the CD34 antigen, a marker of Kaposi's sarcoma
cells, could be of value in the distinction between these two
angioproliferative disorders. We comparatively examined 16 biopsy
specimens from cases of Kaposi's sarcoma and seven biopsies from
patients with pseudo-Kaposi's sarcoma, by a
streptavidin-biotin-peroxidase method, using a monoclonal antibody
to the CD34 antigen. All cases of Kaposi's sarcoma showed CD34
labelling both on endothelial cells and on the characteristic
spindle-shaped, perivascular cells. Biopsies of pseudo-Kaposi's
sarcoma showed a strong labelling of endothelial cells of
hyperplastic vessels. However, in sharp contrast with Kaposi's
sarcoma, a complete absence of perivascular CD34 expression was
noted. It seems therefore that immunolabelling for the CD34
antigen appears to be a valuable tool in the differential
diagnosis between Kaposi's sarcoma and pseudo-Kaposi's sarcoma.
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