In a 57-year-old woman, on the thigh
What to see at dermoscopy:
-absence of pigmented network
-homogeneous pattern
-sharply demarcated
-erythema at periphery
Biopsy was indicated.
Histopathological correlation: thrombosed angiokeratoma
Comments: The differential diagnosis of this lesion includes blue nevus, nodular or metastatic melanoma. The presence of the peripheral erythema around a nevus constitutes a Meyerson´s nevus.
In a 28-year-old man with Fabry´s disease, on the periumbilical area
What to see at dermoscopy:
-absence of pigmented network
-multiple, well-demarcated, blue-red, round to oval structures (lacunae)
-sharply demarcated
Biopsy was indicated.
Histopathological correlation: angiokeratoma
Comments: Fabry´s disease is an uncommon X-linked recessive pathology caused by deficient activity of alpha-galactosidase A. The homozygous males have not only the angiokeratomas (located predominantly in the lower half of the body) but also symptoms related to involvement of other organ systems: renal failure, transient ischemic attacks, myocardial infartion, acroparesthesias and excrutiating pain. Heterozygous females symptoms can range from asymptomatic to full-blown disease as severe as that in affected male patients.