## Basic introduction

  • This a rare skin condition in which there is hyperplasia of pre-existing vasculature arising from venous hypertension from severe chronic venous stasis
  • It is also known as pseudo-Kaposi sarcoma, acroangiodermatitis of Mali-Kuiper, gravitational purpura or stasis purpura
  • Causes include:
  • Venous insufficiency
  • Klippel-Trenaunay syndrome
  • Stump dermatosis in amputees
  • Acquired iatrogenic arteriovenous (AV) fistula
  • Paralyzed limb
  • IV drug abuse
  • Hereditary coagulation defects
  • It is also thought to be a clinical variant of stasis dermatitis
  • Variants of acroangiodermatitis include:
  • Acroangiodermatitis in first pregnancy manifesting as gravity purpura or Dermite ocre of Favre on lower legs over site of venous varicosities
  • Angiodermatitis that happens after placement of the arteriovenous shunt for hemodialysis in chronic renal failure
  • Mali type, which is an exaggerated stasis dermatitis seen in elderly patients (which is usually bilateral associated with chronic venous insufficiency)
  • Stewart-Bluefarb syndrome, which is a congenital arteriovenous malformation of the lower leg with multiple AV shunts
  • Purple-colored patches
  • Plaques or nodules
  • Indurated plaques
  • Generally localized on the dorsal aspect of the foot and the lower aspect of the shin
  • Edema
  • Purple creeping ectatic arterioles on the back of the fingers common after 50yrs
  • Histopathological examination that may reveal the following:
  • Dermal fibrosis
  • Extravasation of RBCs
  • Hemosiderin pigment deposition
  • Newly-formed vessels with thick walls
  • Proliferation of endothelial cells
  • Small thrombi in the lumen
  • Superficial perivascular infiltrate of lymphocytes, histiocytes and occasional plasma cells
  • Sebaceous Adenoma
  • Stasis dermatitis
  • Kaposi sarcoma
  • None is known
  • Treatment of underlying vascular pathology
  • Oral antibiotics such as:
  • Tabs Erythromycin 500mg QID x 3/12
  • Tabs Dapsone 50mg BD x 3/12
  • Topical steroids;
  • Compression stockings
  • Compression pumps
  • Treatment of ulcer
  • Laser ablation.
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