By Gary M. White, MD
Typical grouped vascular papules.
A glomangioma is a congenital, benign, vascular neoplasm associated with loss of function mutations in the globulin gene at chromosome 1p21.
Multiple glomus tumors may develop in childhood, adolescence, or adulthood. These tumors may be multilobular or plaque-like and may have a vascular, cobblestone, or hyperkeratotic surface. They are not easily compressed and compression may aggravate the associated pain. They are most common on the extremities and may be segmental in distribution. One is often able to distinguish glomuvenous malformations (GVMs) from venous malformations (VMs) by clinical features. For example, glomuvenous malformations are typically nodular and scattered, or plaque-like and segmental, with color varying from pink to purplish dark blue, whereas most venous malformations are soft, blue, and often localized vascular lesions. Glomuvenous malformations are usually located on the extremities and involve skin and subcutis, whereas VMs commonly affect muscles and joints. Glomuvenous malformations have a distinct raised, often hyperkeratotic cobblestone-like appearance and cannot be completely emptied by compression, unlike VMs. Glomuvenous malformations are painful by compression, whereas VMs are painful on awakening, after activity, or with hormonal changes. Elastic compressive garments aggravate pain in GVMs, in contrast to VMs.
No treatment is needed. Genetic counseling should be provided. Excision of small lesions may be done, as GVMs usually do not involve deep tissue structures. Laser has been employed successfully, e.g., long-pulsed neodymium:yttrium-aluminum-garnet laser [JAAD 2017;77;473].
Dermatology Online Journal 17(10)
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