Angiokeratoma of Fordyce

Diagnosis: Angiokeratoma of Fordyce

Small red papule with a rough surface on the scrotum.

Clinical Presentation

Small red papule with a rough surface on the scrotum.

Clinical History

Submitted by Alaa Saad. Originally posted September 21, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Melanoma • Pyogenic granuloma • Cherry angioma • Verruca vulgaris • Kaposi sarcoma

Key Learnings

• Vascular papules with overlying hyperkeratosis — dark red to black, firm • Fordyce type: multiple on scrotum/vulva — most common, benign • Mibelli type: on fingers/toes in children (acral) • Fabry disease (angiokeratoma corporis diffusum): widespread angiokeratomas as cutaneous sign of alpha-galactosidase A deficiency • Fabry: X-linked, pain crises, renal failure, cardiac disease — enzyme replacement is available • Solitary angiokeratoma: often on lower extremity, can mimic melanoma

Tags: angiokeratoma, fordyce, alaa saad