Abstract:

Cutaneous collagenous vasculopathy (CCV) is a microangiopathy of superficial dermal blood vessels. First described in 2000, this rare entity has fewer than 50 reported cases to date but underdiagnosis is suspected. Clinically, CCV resembles generalized essential telangiectasia and if a presumptive diagnosis is made, a biopsy is rarely done for histologic confirmation. Even when a biopsy is performed, the findings of CCV are subtle and can often be missed if unaware of the features that distinguish it from other primary telangiectatic processes. We describe a case of a 63-year-old Caucasian male who presented with branched and linear blanchable macules located symmetrically on the upper and lower extremities. Many dilated vessels with thickened vascular walls due to hyaline deposition were noted in the superficial dermis. The eosinophilic amorphous material was periodic acid-Schiff-positive and resistant to diastase. The patients past medical history included type 2 diabetes mellitus and hypertension which have been suggested as possible risk factors for the development of CCV. Several cases of concomitant CCV and one or both of these co-morbidities have been documented proposing that diabetes and hypertension associated microangiopathy could play a role in this condition. Therefore, although thought of as idiopathic, a patients underlying medical history is significant and may contribute to the development of CCV if their disease ultimately leads to damage to the superficial dermal vasculature resulting in reduplication and splitting of the basement membrane collagen surrounding the vessels. Increased awareness of cutaneous collagenous vasculopathy by both dermatologists and pathologists will lead to improved recognition. More reports of this entity may provide insight into the etiology and delineate a clearer association between cutaneous collagenous vasculopathy and certain underlying systemic disease processes.

Financial Disclosure:
No current or relevant financial relationships exist.

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Angelia Stepien, DO