Angiokeratoma of Fordyce: Two unusual case presentations involving lesions on the clitoris and glans penis

Abstract

Angiokeratoma of Fordyce is a benign vascular lesion characterized by the dilation of blood vessels within the papillary dermis, accompanied by epidermal acanthosis and hyperkeratosis. This report presents two clinical cases: a 22-year-old woman with a solitary, prominent nodular lesion on the clitoris and a 26-year-old man with asymptomatic violaceous papules on the glans penis. Both cases underscore the clinical presentation, differential diagnoses, and histopathological findings associated with angiokeratoma. The first case was diagnosed through excisional biopsy, revealing orthohyperkeratosis, parakeratosis, and dilated vascular channels, while the second case was confirmed via punch biopsy. Although angiokeratomas are typically asymptomatic, they may occasionally present with bleeding, highlighting the necessity for clinical vigilance. The rarity of these lesions in the genital region emphasizes the importance of accurate diagnosis and management, as they can mimic more serious conditions, including melanoma.