History:

Angiokeratoma Circumscriptum Naeviforme (Verrucous Vascular Malformation) is a malformation of dermal and subcutaneous capillaries and veins. The vascular malformation is congenital. Over time, a verrucous component appears. The lesions are bluish-red, ill-defined, and occur on the lower extremities mostly, but also on the chest or forearm. Superficial ablative therapy is typically followed by recurrence, regardless of whether ablation is performed by excision, laser, cryotherapy, or electrocautery. The presented case had typical history, however clinically we put three differential diagnoses: lichen planus hypertrophicus, Kaposi sarcoma and angiokeratoma circumscriptum naeviforme.  The histologic changes in skin biopsy fit with the last one.