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Almalki MK, Alhowaish AK, Alharbi AA, Alsehli AM, Makhdoom AK. Acquired Lymphangioma Circumscriptum of the Scrotum: A Case Report. Cureus 2024; 16:e55895. [PMID: 38595904 PMCID: PMC11003562 DOI: 10.7759/cureus.55895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2024] [Indexed: 04/11/2024] Open
Abstract
Lymphangioma circumscriptum (LC) is an uncommon malformation affecting the skin and subcutaneous tissue. This report documents a case of LC that developed in the scrotum of a 35-year-old male. Upon examination, numerous clusters of clear vesicles were found on the scrotum's surface. The patient had no previous exposure to infections, trauma, surgery, or radiation treatment. A skin biopsy revealed enlarged lymphatic channels in the dermis, aligning with a diagnosis of LC. The patient was treated with cryotherapy using liquid nitrogen, specifically targeting the translucent yellowish vesicles. The cryotherapy was administered in a series of eight sessions, each involving double freeze-thaw cycles, spaced out at two-week intervals. Following treatment, the patient's lesions regressed, indicating a favorable therapeutic outcome. The patient was followed up for nearly one year, during which no new lesions developed, suggesting the treatment's effectiveness in preventing recurrence. The complete resolution of lesions and absence of recurrence during follow-up indicate a good prognosis and successful response to cryotherapy. Scrotal LC, particularly the acquired form in adults without any precipitating factors, is extremely rare. This case underlines the need to include acquired LC in the diagnostic considerations when adult patients present with vesicular lesions on the scrotum, to ensure accurate diagnosis and subsequent proper treatment.
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Affiliation(s)
| | | | - Amer A Alharbi
- Dermatology, King Khalid University Hospital, Riyadh, SAU
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Poplausky D, Piontkowski AJ, Phelps RG, Gulati N. Microcystic lymphatic malformation following a double mastectomy. JAAD Case Rep 2024; 44:74-76. [PMID: 38304102 PMCID: PMC10831273 DOI: 10.1016/j.jdcr.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Affiliation(s)
- Dina Poplausky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Austin J. Piontkowski
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert G. Phelps
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
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Wang H, Zhou J, Lin W, Xie C, Yang W, Guo Z. Curettage and sclerotherapy technique: A hybrid approach to superficial lymphatic malformation. Pediatr Dermatol 2022; 40:265-269. [PMID: 36444750 DOI: 10.1111/pde.15202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To describe the curettage and sclerotherapy technique, a hybrid approach to treatment for superficial lymphatic malformations. METHODS A retrospective analysis of a lymphatic malformation data base was performed. Patients with superficial lymphatic malformation treated by curettage and sclerotherapy technique with bleomycin were included in this study. Safety and efficacy of the curettage and sclerotherapy technique with bleomycin were evaluated. RESULTS Between September 2019 and October 2021, 10 consecutive patients (male/female ratio: 4:6; mean age, 10.9 years; range, 3-35 years) presented with superficial lymphatic malformations that were subsequently treated by curettage and sclerotherapy technique with bleomycin. All lesions were located on the trunk and extremities. Each patient received one treatment session and a mean follow-up of 12 months. We observed minor complications. No postoperative infections occurred in this series. No patient developed skin ulceration or necrosis. Scarring and recurrence occurred in one patient. Complete regression was confirmed for all 10 patients by photographic evaluation. CONCLUSION A curettage and sclerotherapy technique is proposed to treat superficial lymphatic malformation in this study. This technique seems to be safe and highly effective.
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Affiliation(s)
- Huaijie Wang
- Department of Pediatric Surgery, Xi'an International Medical Center Hospital, Xi'an, China
| | - Jinbang Zhou
- Department of Pediatric Surgery, Xi'an International Medical Center Hospital, Xi'an, China
| | - Weilong Lin
- Department of Pediatric Surgery, Xi'an International Medical Center Hospital, Xi'an, China
| | - Chong Xie
- Department of Pediatric Surgery, Xi'an International Medical Center Hospital, Xi'an, China
| | - Weijia Yang
- Department of Pediatric Surgery, Xi'an International Medical Center Hospital, Xi'an, China
| | - Zhengtuan Guo
- Department of Pediatric Surgery, Xi'an International Medical Center Hospital, Xi'an, China
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Ghalamkarpour F, Asadi-Kani Z, Moradi A, Zaresharifi S, Khazaei P. Acquired lymphangioma circumscriptum secondary to tuberculosis: A rare case report. Dermatol Ther 2020; 33:e13463. [PMID: 32338408 DOI: 10.1111/dth.13463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/27/2020] [Accepted: 04/21/2020] [Indexed: 11/29/2022]
Abstract
Lymphangioma circumscriptum is a benign lymphatic malformation that usually presents at birth or early childhood. Acquired oral lymphangioma has been reported secondary to radiation therapy and denture-induced trauma due to damage to previously normal lymphatics. To the best of our knowledge, this is the first report of acquired oral lymphangioma due to childhood tuberculous adenitis.
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Affiliation(s)
- Fariba Ghalamkarpour
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Asadi-Kani
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Afshin Moradi
- Department of Pathology, Shohada Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shirin Zaresharifi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pegah Khazaei
- Department of Special Patient Care, Hospital Dentistry Clinic, UCLA School of Dentistry, Los Angeles, California, USA
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Supekar BB, Chopkar AD, Wankhade VH, Singh RP, Bhat DM, Suresh P. Klippel-Trenaunay Syndrome with Arterio-veno-lymphatic Malformation: A Rare Presentation. Indian Dermatol Online J 2020; 11:404-408. [PMID: 32695703 PMCID: PMC7367591 DOI: 10.4103/idoj.idoj_220_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 05/24/2019] [Accepted: 06/05/2019] [Indexed: 01/19/2023] Open
Abstract
Klippel-Trenaunay syndrome (KTS) is a rare disorder characterized by triad of vascular malformations, varicose veins, and bony or soft tissue hypertrophy involving an extremity. Port wine stain is the most common vascular malformation associated with this syndrome. Various other rare vascular malformations described are angiokeratomas, angiokeratoma circumscriptum naeviformae, angiodermatitis, etc. This is the first instance, to the best of our knowledge, describing the capillary, venous, and lymphatic malformations in a same case of KTS.
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Affiliation(s)
- Bhagyashree B Supekar
- Department of Dermatology, Venereology and Leprology, Government Medical College and Hospital, Nagpur, Maharashtra, India
| | - Apoorva D Chopkar
- Department of Dermatology, Venereology and Leprology, Government Medical College and Hospital, Nagpur, Maharashtra, India
| | - Vaishali H Wankhade
- Department of Dermatology, Venereology and Leprology, Government Medical College and Hospital, Nagpur, Maharashtra, India
| | - Rajesh Pratap Singh
- Department of Dermatology, Venereology and Leprology, Government Medical College and Hospital, Nagpur, Maharashtra, India
| | - Dharitri Mukund Bhat
- Department of Pathology, Government Medical College and Hospital, Nagpur, Maharashtra, India
| | - Parvathy Suresh
- Department of Radiology, Government Medical College and Hospital, Nagpur, Maharashtra, India
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Ho VPY, Koh MJA. Vulvar lymphangiectasia secondary to gastrointestinal tuberculosis infection in a teenager. Pediatr Dermatol 2020; 37:215-216. [PMID: 31618790 DOI: 10.1111/pde.13920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We report a rare presentation of vulvar lymphangiectasia that developed secondary to gastrointestinal tuberculosis in a teenager, and its spontaneous resolution after anti-tuberculous treatment was completed.
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Affiliation(s)
- Valerie Pui Yoong Ho
- Dermatology Service, KK Women's and Children's Hospital, Singapore City, Singapore.,General Paediatrics Service, KK Women's and Children's Hospital, Singapore City, Singapore
| | - Mark Jean Aan Koh
- Dermatology Service, KK Women's and Children's Hospital, Singapore City, Singapore
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Gude G, Gupta P, Sharma RK, Rajwanshi A. Primary lymphangioma circumscriptum of the vulva presenting as warty plaques. Australas J Dermatol 2019; 60:305-307. [PMID: 30812056 DOI: 10.1111/ajd.13014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 02/03/2019] [Indexed: 11/28/2022]
Abstract
Lymphangioma circumscriptum is a benign hamartomatous malformation involving the lymphatic system of skin and subcutaneous tissue. It can involve any part of the body with maximum predilection for proximal parts of limbs. Vulvar involvement is quite infrequent. Based on the aetiopathogenesis, it can be either primary or secondary, with the secondary form being relatively more common in vulva. We report an exceedingly rare case of primary lymphangioma circumscriptum in a post-menopausal female presenting with multiple warty, papulo-nodular lesions on both labia majora. The patient was diagnosed histopathologically and managed surgically by wide local excision with primary closure.
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Affiliation(s)
- Geethanjali Gude
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Parikshaa Gupta
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ramesh Kumar Sharma
- Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arvind Rajwanshi
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Bae GE, Yoon G, Song YJ, Kim HS. High-grade squamous intraepithelial lesion arising adjacent to vulvar lymphangioma circumscriptum: a tertiary institutional experience. Oncotarget 2018; 7:48120-48129. [PMID: 27329721 PMCID: PMC5217005 DOI: 10.18632/oncotarget.10158] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 06/06/2016] [Indexed: 11/25/2022] Open
Abstract
Lymphangioma circumscriptum of the vulva occurs in patients who have undergone radical hysterectomy, lymph node dissection, or radiation therapy for management of advanced uterine cancer. Since vulvar lymphangioma circumscriptum typically presents as multiple, grossly verrucous vesicles of various sizes, it may be impossible to clinically distinguish vulvar lymphangioma circumscriptum from other vulvoperineal cutaneous diseases. In the present study, 16 (1.6%) out of the 1,024 vulvar biopsy or excision specimens were diagnosed as lymphangioma circumscriptum. In two (12.5%) out of the 16 cases, unusual histopathological findings were observed. Both patients had previously undergone radical hysterectomy with lymph node dissection and postoperative radiation therapy or concurrent chemoradiation therapy for advanced cervical cancer. Microscopic examination revealed high-grade squamous intraepithelial lesions, which were located immediately adjacent to the normal squamous epithelium covering the dilated subepithelial lymphatic vessels. Further, human papillomavirus genotyping confirmed that both patients were infected with high-risk human papillomavirus. High-grade squamous intraepithelial lesion cannot be grossly distinguished from vulvar lymphangioma circumscriptum because the multiple, verrucous vesicles that constitute the characteristic gross appearance of vulvar lymphangioma circumscriptum hinder its distinction. In this regard, our cases of high-grade squamous intraepithelial lesion, located adjacent to vulvar lymphangioma circumscriptum, support the notion that active surgical excision is necessary for the treatment of vulvar lymphangioma circumscriptum.
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Affiliation(s)
- Go Eun Bae
- Department of Pathology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Gun Yoon
- Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do, Republic of Korea
| | - Yong Jung Song
- Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do, Republic of Korea
| | - Hyun-Soo Kim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Zaballos P, Del Pozo LJ, Argenziano G, Karaarslan IK, Landi C, Vera A, Llambrich A, Medina C, Bañuls J. Dermoscopy of lymphangioma circumscriptum: A morphological study of 45 cases. Australas J Dermatol 2017; 59:e189-e193. [PMID: 28752523 DOI: 10.1111/ajd.12668] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 03/27/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND/OBJECTIVES The dermoscopy of lymphangioma circumscriptum, also known as superficial lymphatic malformation, remains to be clarified. METHODS Digital dermoscopic images of 45 histopathologically confirmed cases of lymphangioma circumscriptum collected from nine hospitals in Spain, Italy and Turkey were evaluated for the presence of dermoscopic structures and patterns. RESULTS Our study shows that the most common structure found in lymphangioma circumscriptum was the presence of lacunae (89% of cases). The latter were red or dark-coloured in 18 cases (45%), yellowish or whitish in 14 cases (35%) and multicoloured in eight cases (20%). The second most common dermoscopic structure was the presence of vascular structures, which were found in 82% of cases, followed by white lines (47%), the hypopyon sign or two-tone lacunae (42%) and scales (7%). CONCLUSIONS Dermoscopy is useful in improving the diagnosis of lymphangioma circumscriptum with characteristic structures and patterns and could assist in elucidating the presence of blood in lymphatic channels.
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Affiliation(s)
- Pedro Zaballos
- Department of Dermatology, Hospital Sant Pau i Santa Tecla, Tarragona, Spain
| | - Luis Javier Del Pozo
- Department of Dermatology, Son Espases University Hospital, Palma, Mallorca, Spain
| | | | | | - Christian Landi
- Dermatology, Department of Surgery, Infermi Hospital, Rimini, Italy
| | - Angel Vera
- Department of Dermatology Maternal and Child Hospital, Carlos Haya, Hospital Málaga, Málaga, Spain
| | - Alex Llambrich
- Department of Dermatology, Son Llàtzer Hospital, Palma, Mallorca, Spain
| | - Carolina Medina
- Department of Dermatology, Dr Negrin University Hospital of Gran Canaria, Gran Canaria, Spain
| | - Jose Bañuls
- Department of Dermatology, General University Hospital of Alicante, Alicante, Spain
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Abstract
Lymphangioma circumscriptum (LC) is a form of lymphangioma characterised by benign dilation of lymphatic channels, which affects the skin and subcutaneous tissues. The most common sites of LC are mucosa of mouth, tongue, groin, axilla, trunk and proximal region of extremities. Vulva is a rare site of LC. In this report, we are presenting a case of LC of vulva occurring in a 60-year-old female without any obvious reason. The patient presented with multiple genital wart-like papular lesions in the vulva. Biopsy of lesion reveals LC. She was treated with vulvectomy and showed no sign of recurrence till date.
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Affiliation(s)
- Anuradha Sinha
- Department of Pathology, Bankura Sammilani Medical College, Bankura, West Bengal, India
| | - Jyoti Prakash Phukan
- Department of Pathology, Bankura Sammilani Medical College, Bankura, West Bengal, India
| | - Shilpa Jalan
- Department of Pathology, Bankura Sammilani Medical College, Bankura, West Bengal, India
| | - Subrata Pal
- Department of Pathology, Bankura Sammilani Medical College, Bankura, West Bengal, India
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Saluja S, Petersen M, Summers E. Fractional carbon dioxide laser ablation for the treatment of microcystic lymphatic malformations ( lymphangioma circumscriptum) in an adult patient with Klippel-Trenaunay syndrome. Lasers Surg Med 2015; 47:539-541. [PMID: 26073570 DOI: 10.1002/lsm.22379] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND Lymphangioma circumscriptum (LC) is a rare, benign, vascular malformation of dilated superficial lymphatic channels. Treatment is typically undertaken for cosmetic reasons or complications such as fluid drainage, pain, and infection risk that can negatively impact quality of life. Management of LC remains challenging because of high recurrence rates, regardless of the treatment modality chosen. OBJECTIVE Treatment of LC with the fully-ablative carbon dioxide (CO2 ) laser has been reported widely, however, treatment with the fractionated CO2 laser has been limited to one case in the pediatric population. Our objective was to test the usefulness of the fractionated 10,600-nm CO2 laser in the management of symptomatic LC in an adult. RESULTS We report a case of a 27-year-old female with Klippel-Trenaunay Syndrome (KTS) who presented with a 5-year history of well-circumscribed lesions on the right lateral and anterior thigh that drained clear lymphatic and serosanguineous fluid, respectively. These lesions caused her significant emotional distress because of extensive drainage. After only one treatment utilizing the fractionated 10,600-nm CO2 laser, the patient had improvement with cessation of fluid drainage, and the lesions are still asymptomatic 6 months since initial treatment. CONCLUSION The favorable results observed in our patient suggest that fractionated CO2 laser may be an additional well-tolerated, low downtime option for palliation of symptoms in patients with LC. We recognize that short-term follow-up cannot conclusively demonstrate effectiveness and durability of this treatment and that, given the high risk of recurrence, a longer-term observation is needed before making definite conclusions. Lasers Surg. Med. 47:539-541, 2015. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Sandeep Saluja
- Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Marta Petersen
- Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Erika Summers
- Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah
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Abstract
Lymphatic malformations, or lymphangiomas, are benign proliferations of lymphatics, classified as superficial lymphangioma circumscriptum (LC) and deep (cavernous lymphangioma). LC, as the name suggests, is a well-circumscribed lesion but, rarely, extensive and invasive forms can also be seen. Surgical excision is the main modality of treatment. We report a case of extensive and invasive type of LC where surgical excision is difficult and recurrence is the rule.
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Affiliation(s)
- Mohan H Kudur
- Department of Dermatology, Srinivas Institute of Medical Sciences and Research Centre, Mukka, Surathkal, Mangalore, India
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Bhat RM, Saldanha CS, Kambil SM, Dandakeri S. Cutaneous lymphangiectasia of the vulva secondary to tuberculosis. Indian J Sex Transm Dis AIDS 2012. [PMID: 22529452 PMCID: PMC3326847 DOI: 10.4103/2589-0557.93817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Cutaneous lymphangiectasia, also called as acquired lymphangioma, is a benign cutaneous disorder involving the dermal and subcutaneous lymphatic channels. It can rarely occur on the vulva. We describe a 35-year-old woman who came with multiple raised lesions over the vulva and left upper thigh of 1 year duration. She gave history of getting treated for multiple swellings that developed over right side of the neck and inguinal regions on both sides three decades ago. On local genital examination, the patient had a large polypoidal growth involving both sides of the vulva, left upper thigh, and over pubic area. Multiple linear scars were present over the upper thighs and groin bilaterally. The patient underwent simple vulvectomy and left thigh growth excision. Histopathological examination of the vulvectomy specimen confirmed our diagnosis.
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Affiliation(s)
- Ramesh M. Bhat
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India,Address for correspondence: Dr. Ramesh M. Bhat, Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Kankanady, Mangalore - 575 002, India. E-mail:
| | - Celia S. Saldanha
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Srinath M. Kambil
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - S. Dandakeri
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
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