From the Research
Targetoid hemosiderotic hemangioma is a benign vascular tumor of the skin that can be effectively managed with simple surgical excision if desired for cosmetic reasons or diagnostic confirmation, as stated in the most recent and highest quality study 1.
Key Characteristics
- Typically presents as a small, solitary lesion with a characteristic targetoid appearance—a central brown-purple papule surrounded by a pale area and an outer ecchymotic ring
- Most commonly affects adults with an age range from 9 to 78 years and has no gender predilection
- The lesion is thought to arise from trauma, leading to micro-shunts between small lesional capillaries and adjacent lymphatic vessels
- Histologically, it shows dilated vascular channels lined by hobnail endothelial cells, red blood cell extravasation, hemosiderin deposition, and mild lymphohistiocytic infiltrates
- Immunohistochemistry is positive for D2-40, a lymphatic endothelial marker
Diagnosis and Treatment
- Dermoscopy can be helpful in improving the diagnosis of targetoid hemosiderotic hemangioma, with the presence of central red and dark lacunae and a peripheral circular reddish-violaceous homogeneous area being the most common dermoscopic pattern 2
- Simple surgical excision is the standard approach for treatment, with an excellent prognosis and no risk of malignant transformation or recurrence after complete removal
- It is essential to recognize this condition to avoid confusion with more concerning entities like Kaposi's sarcoma or melanoma
Important Considerations
- Targetoid hemosiderotic hemangioma should be classified as a lymphatic vascular malformation, as suggested by the positive D2-40 immunostaining in all cases studied 3
- The lesion is generally asymptomatic and may change in appearance over time, sometimes expanding and developing its targetoid pattern after minor trauma
- A low Ki-67 proliferation index indicates a low proliferative nature of these lesions, supporting their benign nature 3