Acta Dermato-Venereologica 98-8CompleteContent | Page 31

QUIZ SECTION Slowly Progressing Asymptomatic Disseminated Telangiectasias: A Quiz Justyna SZCZĘCH, Marcelina POJAWA-GOŁĄB, Dominik SAMOTIJ and Adam REICH* Department of Dermatology, University of Rzeszow, PL-35-055 Rzeszow, Poland. *E-mail: [email protected] We describe here 2 patients with disseminated telangiecta- sias who were seen recently in our unit. The same condition was diagnosed in both individuals. The first case was a 66-year-old man with telangiectasias that had developed when he was 44 years old. The skin lesions were initially located symmetrically on his lower limbs, but over time were slowly progressing towards his upper limbs (Fig. 1a). His face and neck were spared and only singular lesions were noticeable on the chest. On physical examination, the patient demonstrated widespread, symmetrically distributed tree-like branching telangiecta- sias. Neither oral mucous membrane involvement nor nail plate abnormalities were observed. The patient did not report any additional symptoms. The second case was a 33-year-old woman with similar skin lesion morphology and pattern, but with more extensive involvement than in the first case. She had symmetrically disseminated telangiectasias, which formed confluent vio- laceous patches on her lower limbs, buttocks, trunk and arms (Fig. 1b). She first developed skin changes in her late 820 Fig. 2. Histological changes in the biopsy specimens obtained from: (a) the male patient; and (b) the female patient. Dilated thickened small blood vessels in the superficial dermal plexus (Periodic acid-Schiff, ×200). (b) Similar histological changes as in (a), using a different staining method (trichrome, ×200). teens. Dermoscopically, the lesions revealed straight and serpentine abundant telangiectatic vessels following a tree- like branched pattern (Fig. 1c). Similarly to the first case, no lesions were observed on her oral mucosa or nail plates. She had no history of abnormal bleeding, and was not diagnosed with any other systemic disorder. Histological examination of skin biop- sies showed almost identical features in both cases. Thickening of the walls of the multiple superficial dermal blood vessels containing hyaline material was identified by Periodic acid-Schiff (PAS) staining (Fig. 2a) and trichrome staining (Fig. 2b). Fig. 1. Clinical presentation of the condition in: (a) the male patient; and (b and c) the female patient. (a) Erythematous, mottled, telangiectatic macules extensively involving the extremities. (b) Diffuse telangiectasias on the lower limbs coalescent into purple-blue patches. (c) Dermoscopic appearance of the forearm telangiectasia: straight and serpentine vessels following a tree-like branched pattern (x10). doi: 10.2340/00015555-2956 Acta Derm Venereol 2018; 98: 820–821 What is your diagnosis? See next page for answer. This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Journal Compilation © 2018 Acta Dermato-Venereologica.