Diagnosis: Angiokeratoma corporis diffusum with normal enzyme activities.
MICROSCOPIC FINDINGS AND CLINICAL COURSE
Histologic examination of multiple verrucous leg lesions showed sharply demarcated, verrucous epidermal hyperplasia; numerous dilated, papillary, dermal blood vessels adjacent to the epidermis; and subcorneal and dermal erythrocyte extravasation, consistent with angiokeratoma. Differentiation from verrucous hemangioma was made on the basis of the lack of deep dermal or subcutaneous extension in all the skin lesions sampled.
Tissue cultures were positive for mixed flora and negative for fungi and mycobacteria. The results of the following laboratory investigations were normal: blood chemistry profile, complete blood cell count, and 24-hour urine collection. Serologic testing revealed negativity for human immunodeficiency virus and normal levels of the following enzymes: 
-galactosidase A, -fucosidase, 
-galactosidase, and -mannidase. Also, electron microscopy revealed no lysosomal inclusions in the endothelial cells, pericytes, or fibroblasts.
The patient was treated with systemic antibiotics and periodic surgical debulking of numerous angiokeratomas on his legs, which resulted in significantly improved control of chronic cutaneous . . . [Full Text of this Article]
DISCUSSION
