Angiokeratomas are acquired vascular lesions that present as shiny, soft, dark red to violaceous, 2–10 mm papules which may develop a blue-violaceous to black color and a surface scale. Four clinical subtypes of angiokeratomas have been described: solitary angiokeratoma (the most common type), angiokeratoma of Mibelli, angiokeratoma of Fordyce, and angiokeratoma corporis diffusum.
- Dark lacunae: sharply demarcated, ovoid structures with a dark blue, dark violaceous or black color.
- Blue-White veil: confluent blue pigmentation with an overlying whitish haze.
- Ulceration and surface scale may be present.
- Rarely, rainbow pattern may be present.