Angioma serpiginosum is an uncommon benign skin disorder characterized by asymptomatic clusters of nonpurpuric punctate erythematous lesions. The rash is asymptomatic but may lead to cosmetic problems and can be treated by laser therapy. Women are most commonly ... Angioma serpiginosum is an uncommon benign skin disorder characterized by asymptomatic clusters of nonpurpuric punctate erythematous lesions. The rash is asymptomatic but may lead to cosmetic problems and can be treated by laser therapy. Women are most commonly affected, and the disorder is most often sporadic, although rare families suggestive of autosomal dominant inheritance have been reported (Sandhu and Gupta, 2005). No male-to-male transmission has been described, but father-to-daughter transmissions are known. It has been suggested that the pattern of skin involvement may be due to cutaneous somatic mosaicism (Chen et al., 2006; Blinkenberg et al., 2007). An X-linked dominant form of angioma serpiginosum (300652) has been mapped. The few males described may actually represent somatic mosaicism of an X-linked gene.
Angioma serpiginosum was first described by Jonathan Hutchinson (1889) in Plate IX of Vol. 1 of his Archives of Surgery. More common in females, the condition begins before puberty as pin-sized capillary puncta affecting any part of the ... Angioma serpiginosum was first described by Jonathan Hutchinson (1889) in Plate IX of Vol. 1 of his Archives of Surgery. More common in females, the condition begins before puberty as pin-sized capillary puncta affecting any part of the body surface except the palms and soles and also sparing oral mucous membranes. Marriott et al. (1975) reported 2 kindreds with several affected individuals, consistent with dominant inheritance and reduced penetrance; no male-to-male transmission was observed. Blinkenberg et al. (2007) commented that the large family reported by Marriott et al. (1975) did not exclude X-linked dominant inheritance. Gerbig et al. (1995) reported a 34-year-old woman with angioma serpiginosum on the medial aspect of the left thigh extending to the groin and lower abdomen and on the volar aspect of the left forearm. Distribution was along the lines of Blaschko. Reexamination of earlier cases revealed that 6 of 7 had distribution of the lesions along the lines of Blaschko. Al Hawsawi et al. (2003) reported an adolescent boy with angioma serpiginosum distributed in a linear pattern along the upper extremity. Skin biopsy showed the characteristic numerous thick-walled capillaries in the dermal papillae. Sandhu and Gupta (2005) reported a father and daughter with angioma serpiginosum. Examination revealed irregular areas of multiple red puncta varying in size from 0.5 to 1 mm with minimal background erythema. The daughter had lesions covering the extensor aspect of the upper arm and lower abdomen; the father had bilateral distribution over the arms and buttocks. Skin biopsy showed dilated vessels in distended dermal papillae. A second unrelated woman had more extensive involvement with lesions over the lower legs, buttocks, trunk, and upper limbs. Chen et al. (2006) described a 15-year-old Taiwanese girl with angioma serpiginosum arranged in a systematized segmental pattern with a midline separation. The spots first appeared at age 7 years on the anterior aspect of the right thigh and subsequently involved the right buttock, left upper quadrant of the abdomen and left back, posterolateral left leg and radial surface of the right arm. Physical examination revealed nonblanchable coppery to bright-red punctate lesions measuring up to 1 mm in diameter and grouped in patches. There was no family history of the disorder. Chen et al. (2006) suggested that the pattern of involvement may be due to cutaneous mosaicism, although it did not fit clearly into the accepted classification system of dermatologic mosaic patterns. The authors stated that sporadic cases may represent segmental manifestation of a disorder that can be transmitted as an autosomal dominant trait.