Hypopyon-like features: new dermoscopic criteria in the differential diagnosis of cutaneous lymphangioma circumscriptum and haemangiomas?

Aminolevulinate photodynamic therapy (ALA-PDT) combined with fire needle for vulva lymphangioma circumscriptum

Lymphangioma is a rare benign lymphatic system proliferation, especially in the vulva. The general treatment principle is determined by clinical manifestations, lesion size, anatomic location, and complications. Treatment options include surgical excision, carbon dioxide laser, cryotherapy, electrocoagulation, and sclerosing agent injection. In the absence of evidence to guide the choice of significant treatment modalities, treatment options are often based on the experience of the treatment team and the patient's preferences. This study presents a case of primary vulva lymphangioma circumscriptum treated with fire needle therapy, photodynamic therapy, and cryotherapy. Furthermore, the combination of fire needle and photodynamic therapy demonstrated exceptional comprehensive effects in pain, wound healing and cosmetic.

Diagnostic Values of Dermatoscopy and CD31 Expression in Cutaneous Lymphangioma Circumscriptum

Background: Cutaneous lymphangioma circumscriptum is characterized by clusters of deep-seated, vesicle-like papules. Cutaneous lymphangioma circumscriptum (CLC) is not a tumor but rather a congenital malformation of superficial lymphatics.

Objectives: The study aimed to describe the dermoscopic features of CLC and investigate the reason why marked blood components in CLC. Moreover, this study sought to increase awareness of the clinical characteristics of CLC and provide insights into CLC diagnosis.

Methods: A representative sample of patients with CLC with demographic information and pathological and dermoscopical results was analyzed. The immunohistochemistry of lymphangioma specimens with CD31 and D2-40 was performed. The clinical manifestations of CLC, demographic information, and the results of immunohistochemistry were statistically analyzed to validate the correlation.

Results: Besides the pattern of frog spawn-like blisters, lymphangioma also presented as either transparent or pigmented with dark-red to whitish/yellowish shades. Moreover, lymphangioma manifested as a pattern of dermatofibroma. Furthermore, CD31 was detected in the flattened endothelium and only present in dilated spaces containing enough blood or lymph components.

Limitations: This study is limited by its retrospective nature and statistical power.

Conclusion: Dermoscopy is useful for the diagnosis of CLC. CD31 positive staining and cystic-dilated spaces showed flattened inner and outer endothelia are the diagnostic features in hypopyon-like shape and blisters resembling frog spawn patterns in CLC. These features can assist in the diagnosis of CLC.

Klippel-Trenaunay Syndrome with Arterio-veno-lymphatic Malformation: A Rare Presentation

Klippel-Trenaunay syndrome (KTS) is a rare disorder characterized by triad of vascular malformations, varicose veins, and bony or soft tissue hypertrophy involving an extremity. Port wine stain is the most common vascular malformation associated with this syndrome. Various other rare vascular malformations described are angiokeratomas, angiokeratoma circumscriptum naeviformae, angiodermatitis, etc. This is the first instance, to the best of our knowledge, describing the capillary, venous, and lymphatic malformations in a same case of KTS.

Acral congenital superficial dermal lymphatic malformations in two unrelated cats: clinicopathological, dermoscopic and ultrastructural findings

BACKGROUND

Cutaneous vascular malformations (CVM) represent a spectrum of human diseases identified at birth or in paediatric patients and classified according to the type of vessel affected. Confusing classification in human medicine has led to misdiagnoses and frequent nomenclature revision. Cutaneous lymphatic malformations (CLM) are reported sporadically in humans.

OBJECTIVE

To describe the clinicopathological findings of superficial dermal cutaneous lymphatic malformations (SDCLM) in two cats.

ANIMALS

Two unrelated adult domestic short hair cats.

METHODS

The two cats were evaluated clinically and with a dermoscope for recurrent swelling and presence of vesicles oozing serosanguineous fluid affecting the right and left hind foot, respectively, since birth. Skin biopsy specimens were collected for histopathological and immunohistochemical evaluation and electron microscopy.

RESULTS

A CVM was suspected based on the age of onset, clinical signs, results of diagnostic imaging and histopathological findings. Dermoscopy was used to describe the alterations of the skin surface. The involvement of the lymphatic vessels was confirmed using immunohistochemical findings and electron microscopy.

CONCLUSION AND CLINICAL IMPORTANCE

To the best of the authors' knowledge, this is the first description of the clinical, dermoscopic, histopathological and ultrastructural characteristics of SDCLM in cats resembling the human counterpart. SDCLMs are rare conditions and appropriate histopathological and immunohistochemical confirmation is required to avoid misdiagnosis and mistreatment.

Cutaneous Lymphangioma Circumscriptum Occurred Seven Years after Surgery with Soft Tissue Cystic Lymphangioma

Lymphangiomas are rare benign congenital lymphatic malformations. They can be divided into three groups: cutaneous lymphangioma circumscriptum (CLC), cavernous, and cystic. CLC is the most common type, and rarely occurs with cavernous or cystic lymphangioma under the lesion. Here, we describe the case of a 9-year-old girl who presented with an asymptomatic vesicular lesion on her back. She was finally diagnosed with CLC by clinical manifestations, dermoscopic findings, and histologic findings. Seven years ago, there was a history of surgical operation in the department of general surgery, and the surgery was soft tissue cystic lymphangioma removal surgery. There was no skin lesion for seven years after surgery, but one occurred a month ago. Herein, we present a case of CLC that occurred after a long interval after surgery for soft tissue cystic lymphangioma.

Cutaneous lymphangioma circumscriptum: The relevance of clinical, dermoscopic, radiological, and histological assessments

Cutaneous lymphangioma circumscriptum (CLC) is a rare congenital malformation of the superficial cutaneous lymphatic ducts. Case report: A 7-year-old boy presented plaque with grouped vesicles resembling a "frog spawn" on the upper left thigh, since 4 months old. The clinical, dermatoscopic and histopathological correlation is of great importance.

Dermatoscopy of Vascular Lesions

Cutaneous vascular lesions (VLs) represent a very common reason for dermatologic consultation for patients. In most cases, VLs are benign and self-limiting. However, because they often mimic malignant skin tumors, their correct and prompt identification is very important in daily practice. Dermoscopy may play a key role in achieving that purpose. This article reviews current knowledge of dermoscopic features of the most frequent VLs.

Dermoscopy of cutaneous lymphangioma circumscriptum

Lymphangiomas are congenital lymphatic malformations. They are clinically characterized by clusters of translucent vesicles, and on dermoscopy, yellow lacunae surrounded by pale septa as well as reddish to bluish lacunae have been described. A young male presented with a seven-year history of a vesicular lesion. Dermoscopy revealed multiple white-yellowish well-circumscribed roundish areas (lacunae) surrounded by pale septa. A few lacunae contained blood, which was characteristically accumulated in the lowest part of the lacuna, resulting in an appearance similar to the so-called "hypopyon" of the eye. We suggest a new "dermatologic" metaphoric term to desrcibe this peculiar feature (half-and-half lacuna).

Cutaneous Lymphangioma circumscriptum - dermoscopic features

Lymphangiomas are congenital lymphatic malformations and cutaneous lymphangioma circumscriptum is the most common type. It is clinically characterized by clusters of translucent vesicles and the presence of dermoscopically yellow lacunae surrounded by pale septa, as well as reddish to bluish lacunae. In our case, the recently described hypopyon-like feature manifested, aiding in the sometimes difficult differential diagnosis of cutaneous lymphangioma circumscriptum with vascular lesions, further highlighting the importance of dermoscopy in what can be a diagnostic challenge.