Angiokeratoma of tongue

Puneet Bhargava, Seema Bhargava, Deepak Mathur, US Agarwal, Rishi Bhargava

 Department of Dermatology S.M.S. Medical Collage, Jaipur (Rajasthan), India

Correspondence Address:
Puneet Bhargava
Department of Dermatology S.M.S. Medical Collage, Jaipur (Rajasthan)
India

Introduction

Angiokeratomas are a group of several unrelated conditions characterised by asymptomatic hyperkeratotic vascular skin lesions and a histological combination of superficial dermal vascular ectasia and hyperkeratosis.

The following five varieties are generally recognised. (a) Angiokeratoma circumscriptum-- Presenting at birth or in early childhood as deep blue to blue, fairly extensive hyperkeratotic plaques situated unilaterally on a lower leg, foot, thigh, buttock or elsewhere. (b) Angiokeratoma of Fordyce- -Presenting as 3-4 mm, dark red or black papules scattered over scrotum/ vulva of elderly persons.(c) Angiokeratoma of Mibelli- Presenting in a female adolescent after a history of trauma/ chill blains as dark red, warty papules on bony prominences of elbows, knees, digits and dorsa of hands. (d) Solitary angiokeratoma- Presenting as a small warty red blue/ black papules usually after external trauma on any anatomical site but favouring lower extremities. (e) Angiokeratoma corporis diffusum-- Presenting as dark red/ punctate papules 1-4 mm in diameter mainly on the lower extremities, lower part of abdomen, genitalia and buttocks in patients with deficiency of alpha-galactosidase.

We describe here a case report of 5 -year- old child with lesions of angiokeratoma on tongue.

Case Report

A 5- year -old male child was referred to the department of Dermatology, SMS Medical College, Jaipur with presence of 1-3 mm, red-blue, warty and non-warty papules of 2 years duration located over the entire dorsal and lateral surface of tongue [Figure - 1]. There was no history of trauma prior to occurrence of lesions. Patient′s father complained that there was bleeding from lesions on scratching. General physical and systemic examination revealed no other abnormality. Diascopy of lesions showed telangiectatic vessels. Biopsy from one of the lesions revealed hyperkeratosis and acanthosis with telangiectatic vessels in lamina propria. Other routine laboratory investigations were within normal limits.

Discussion

Mibelli (1891) first introduced the term angiokeratoma.[1] Fordyce (1896) published the first report of an angiokeratoma on scrotum.[2] Fabry in 1898 described an angiokeratoma that was associated with cardiac, renal and ocular abnormalities and in 1915 called attention to angiokeratoma circumscriptum.[3],[4] Finally Imperial and Helwing identified solitary angiokeratoma as a distinct lesion.[5] We have described an entirely new entity which doesn′t fit into any of the previously described varieties of angiokeratomas.

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