Angiokeratoma

Angiokeratomas are small dark red to purple raised spots. They may also have a rough scaly surface. They are composed of superficial blood vessels (dilated capillaries). Often unnoticed, they may become crusty and bleed if accidentally scratched or damaged, or a harmless clot may form in the lesion (thrombosis), overnight changing the color to dark purple or black.

• Sporadic angiokeratoma
• Angiokeratoma of Fordyce
• Angiokeratoma circumscriptum
• Fabry syndrome (angiokeratoma corporis diffusum)

Apart from Fabry syndrome, which is caused by a genetic defect, the cause of other angiokeratomas is unknown.

Angiokeratomas are harmless surface vascular lesions that can usually be left alone. As the black spots sometimes resemble melanoma, a skin biopsy may be performed to rule out malignancy and allay any fears.

If bleeding becomes a concern or a treatment is requested for cosmetic purposes, they can be removed. Surgical options include excision, laser therapy, pulse dye laser, cryotherapy or electrocautery.