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Angiokeratoma of Fordyce : Everything You Need to Know

Angiokeratoma of Fordyce causes bumps on the scrotum or vulva that may look like genital warts.
Angiokeratomas are small discolored bumps that form when capillaries grow or open up and the overlying skin thickens, giving a rough or pebbly appearance. There are different types of angiokeratomas.
What causes angiokeratomas?
  • Angiokeratomas are not contagious. Some people opt for treatment if the bosses bleed, cause pain, or damage their appearance.

What is an angiokeratoma?

  • Angiokeratomas are hard bumps on the skin. The condition occurs when tiny blood vessels called capillaries grow or open near the surface of your skin and the surface of your skin thickens. 
  • Red, blue, purple, or black bumps form under your skin. Angiokeratomas are a type of non-cancerous (benign) tumor.

What is the definition of angiokeratoma?

  • In Greek, angiokeratoma means:
  • Angio: Vessels.
  • Kera: Horn.
  • Volume: Tumor.

What are capillaries?

  • Capillaries are the smallest blood vessels in your circulatory system. They are so small (about the size of a pen point) that you need a microscope to see them.
  • Your body has about 10 billion capillaries. They connect arteries and veins so that oxygen and nutrients in your blood can reach cells throughout your body.


What are the types of angiokeratomas?

  • Angiokeratomas affect the middle layer (dermis) and the top layer (epidermis) of your skin. There are different types of angiokeratomas:

Fordyce's angiokeratomas

  • Fordyce's angiokeratomas are most often located on your scrotum or penis (parts of the male reproductive system). Less often, it affects your vulva (part of the female reproductive system). It is also known as angiokeratoma of the scrotum or angiokeratoma of the vulva. 
  • Some people develop several or even hundreds of angiokeratomas. Fordyce's angiokeratoma most commonly affects people aged 50 or older. Similar lesions known as angiomas sometimes affect people who are pregnant or using some type of hormonal birth control.

Mibelli's angiokeratoma

  • Mibelli's angiokeratoma most commonly affects adolescent girls who are designated female at birth (DFAB). The skin lesions usually appear on the webbing between the fingers and toes. 
  • They can also form on your knees, elbows, and breasts. These lesions tend to bleed easily.

Angiokeratoma circumscriptum

  • Angiokeratoma circumscriptum causes flat, discolored lesions that are present when a baby is born. Over time, the lesions turn into raised red scaly patches of skin that may bleed. These plates can be less than half an inch. In rare cases, they can cover a quarter of your body. The bumps most often appear on one side of your buttocks or thigh. 
  • Some children have lesions in the neck, trunk, scrotum or tongue. This type is very rare, and it is the only type more common in DFAB people.

Angiokeratoma corporis diffusum

  • Angiokeratoma corporis diffusum occurs in people with lysosomal storage diseases like Fabry disease. These inherited metabolic disorders affect your body's ability to break down certain waste products. 
  • Skin lesions usually appear on your genitals, abdomen, and the “swimming trunk” area between your hips and knees. They can form during childhood, adolescence or adulthood.

How common are angiokeratomas?

  • Angiokeratomas are rare, affecting about 0.16% of Americans - less than 2 in 1,000. About 14% of all angiokeratomas are Fordycean angiokeratomas (angiokeratoma of the scrotum). 
  • This type primarily affects white males or that designated male at birth (DMAB).

What causes angiokeratomas?

  • Angiokeratomas occurs when the tissues that support the capillary walls lose their elasticity. These can be genetic. It can also be due to vascular malformations, pressure on blood vessels, or chronic irritation. Stiffened capillaries swell and can open.
  • The same thing happens when you have spider veins. With an angiokeratoma, the enlarged capillary grows into your skin. It forms a raised, discolored bump called a papule.
  • Swollen veins in your scrotum (varicoceles) or inguinal hernias can put pressure on the capillaries. This leads to an angiokeratoma of the scrotum. Also, pressure during pregnancy can cause vulvar angiokeratoma.
  • Sometimes a solitary angiokeratoma develops in an injured area of ​​the body years after a trauma.


What are the symptoms of angiokeratoma?

  • Angiokeratomas look like warts. They can appear anywhere on your body. The bumps usually start out red, then darken to black or purple with thickened overlying skin. They are less visible on darker skin tones.
  • When you press on a lesion, it does not lighten (whitens). You may have one skin lesion (solitary angiokeratoma) or up to 100 lesions.
  • Angiokeratomas are domed, firm or hard to the touch, red, blue, purple or black, smaller than a quarter inch (5 millimeters), rough on the surface, with a pebbly or scaly texture and appearance.

What are the risk factors for angiokeratoma?

  • Anyone can develop angiokeratomas. Some types are more common in certain ages and genders.
  • For example, white men and people with DMAB are more prone to angiokeratoma of the scrotum (Fordyce). People with lysosomal storage disorders are more likely to develop corporis diffusum angiokeratoma.

What are the complications of angiokeratomas?

  • Some angiokeratomas are more prone to bleeding, even when lightly bumped. And some people find the bumps irritating. Other problems include itching or a burning sensation.
  • Angiokeratomas can develop blood clots. These blood clots are not dangerous like those that can cut off your body's blood supply. These clots do not put you at risk of stroke or heart attack. But they can be painful.

How are angiokeratomas diagnosed?

  • For a diagnosis, you might see a dermatologist. This doctor specializes in the diagnosis and treatment of skin conditions.
  • Although angiokeratomas are not skin cancers, some lesions can mimic melanoma. Your healthcare provider may use a microscope to see skin lesions more clearly (dermoscopy). You may also need a skin biopsy to rule out cancer.

Is there a cure for angiokeratoma?

  • Angiokeratomas do not go away on their own. Sometimes they grow and multiply.
  • Most angiokeratomas do not require treatment. However, you can choose to seek treatment if you feel embarrassed by their appearance. Treatment is also an option if the skin lesions bleed, itch, or cause other problems.
  • Treatments take place in your health care provider's office. You may receive local anesthesia to numb your skin. You should be aware that some treatments for angiokeratomas can cause scarring.

    • Your healthcare provider may perform any of these treatments:
    • Cryotherapy using freezing temperatures to remove the skin lesion.
    • Electrosurgery or fulguration to heat and destroy the skin lesion.
    • Laser surgery (ablation) using high intensity beams of light to get rid of the lesion.
    • Cutaneous excision to remove the damaged capillary.

Is an angiokeratoma an STD?

  • No, angiokeratomas are not sexually transmitted diseases or infections (STD or STI). You can't catch someone else's angiokeratomas. 
  • Angiokeratoma of the scrotum or angiokeratoma of the vulva lesions may resemble genital warts. Your healthcare provider may perform a skin biopsy to make a diagnosis.

Can treated angiokeratomas reappear?

  • Treated angiokeratomas are unlikely to come back. However, new skin lesions may develop in other places on your body.

Is angiokeratoma a type of skin cancer?

  • No, angiokeratoma is not skin cancer. Having the condition does not increase your risk of cancer.

Angiokeratomas are small discolored bumps that form when capillaries grow or open up and the overlying skin thickens, giving a rough or pebbly appearance. There are different types of angiokeratomas. Fordyce's angiokeratoma causes bumps on the scrotum or vulva that may look like genital warts. Talk to your health care provider if the skin lesions make you self-conscious about your appearance or if the lesions bleed, itch, or cause pain. Treatments can help.


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