Angiokeratoma of Fordyce

Angiokeratoma refers to a benign vascular telangiectasia in the papillary dermis that is associated with hyperkeratosis of the epidermis. Clinically, angiokeratoma of Fordyce presents as multiple, well-circumscribed, dome-shaped papules, sized 2 to 5 mm in diameter mainly on the scrotum. The lesions are usually bilateral. The color of the lesions may be red, blue, purple, dark red, or bluish-black. Newer lesions are often smaller, red, soft, compressible, and smooth while longstanding lesions are often larger, darker, firm, non-compressible, keratotic, scaly, and sometimes, warty. Most lesions are asymptomatic but irritation, pain, burning sensation, and itching may occasionally occur. Treatment is not required for the majority of patients with angiokeratoma of Fordyce apart from reassurance. For those who would like to have treatment for cosmetic reasons and for symptomatic lesions, treatment options include surgical excision, cryotherapy, electrocoagulation, sclerotherapy, and laser therapy. Correspondence to: Dr. Alexander K.C. Leung, Clinical Professor of Pediatrics, University of Calgary, Pediatric Consultant, Alberta Children’s Hospital, #200, 233–16th Avenue NW, Calgary, Alberta, Canada T2M 0H5, Tel: (403) 230-3322; E-mail: [email protected]