Abstract

Cutaneous collagenous vasculopathy (CCV) is an idiopathic microangiopathy involving the superficial cutaneous vasculature. It presents as asymptomatic telangiectasia that start on the lower extremities and slowly progresses in generalized fashion mimicking generalized essential telangiectasia. This is a rare entity with less than 50 cases reported in the literature, although it may be under recognized. We report a 50-year-old woman with past medical history significant for essential hypertension, hyperlipidemia, and obesity presenting to dermatology with telangiectatic purple macules and patches that first started on the left lower leg and slowly progressed proximally and to both legs over the course of 6 years. The lesions were asymptomatic and unimproved with compression stocking use. Histopathology of a purple macule demonstrated dilated vessels in the superficial dermis with mural thickening highlighted by PAS stain, compatible with cutaneous collagenous vasculopathy. The clinical and histopathologic findings are consistent with previously reported cases affecting middle-aged women with median duration of symptoms of 7 years and supports the slow-progressing and asymptomatic nature of the entity. Although patients with CCV are reported to have diabetes mellitus (29.2%), hypertension (41.2%), and dyslipidemia (20.6%), clear association with any risk factors or medications have not been established. Our patient is undergoing treatment with laser therapy to help treat the clinical appearance. This case adds to the sparse but growing literature of an uncommon condition.

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