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Angiokeratoma

Enlarged capillaries can form angiokeratomas, wart-like bumps, under your skin. The most common type — angiokeratoma of Fordyce — forms red or black bumps on your scrotum or vulva. It may resemble genital warts. Angiokeratomas aren’t contagious. Some people opt for treatment if the bumps bleed, cause pain or affect appearance.

Overview

A purplish-black angiokeratoma with a reddish border.
Angiokeratomas (a type of noncancerous tumor) may be red, blue, purple or black.

What is angiokeratoma?

Angiokeratomas are hard bumps on your skin. The condition occurs when tiny blood vessels called capillaries get bigger or break open near your skin’s surface and the surface of your skin thickens. Red, blue, purple or black bumps form underneath your skin. Angiokeratomas are a type of noncancerous (benign) tumor.

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What is the definition of angiokeratoma?

In Greek, angiokeratoma means:

  • Angio: Vessels.
  • Kera: Horn.
  • Toma: Tumor.

What are capillaries?

Capillaries are the smallest blood vessels in your circulatory system. They’re so tiny (about the size of a pen dot) 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.

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What are the types of angiokeratomas?

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

Angiokeratoma of Fordyce are most commonly 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’s also known as angiokeratoma of the scrotum or angiokeratoma of the vulva. Some people develop many — even hundreds — of angiokeratomas. Angiokeratoma of Fordyce most commonly affects people aged 50 or over. Similar lesions known as angiomas sometimes affect people who are pregnant or using a hormonal type of birth control.

Angiokeratoma of Mibelli most commonly affects adolescents who are designated female at birth (DFAB). Skin lesions typically appear on the webbing between fingers and toes. They may also form on your knees, elbows and breasts. These lesions tend to bleed easily.

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 plaques may be smaller than half an inch. In rare instances, they may cover a quarter of your body. Bumps most commonly appear on one side of your butt or thigh. Some children have lesions on their neck, trunk, scrotum or tongue. This type is very rare, and it’s the only type more common in people DFAB.

Angiokeratoma corporis diffusum occurs in people who have lysosomal storage diseases like Fabry disease. These inherited metabolic disorders affect your body’s ability to break down certain waste products. Skin lesions typically show up on your genitals, abdomen and the “swimming trunk” area between your hips and knees. They may form during childhood, adolescence or adulthood.

How common are angiokeratomas?

Angiokeratomas are rare, affecting approximately 0.16% of Americans — fewer than 2 in 1,000. About 14% of all angiokeratomas are angiokeratomas of Fordyce (angiokeratoma of the scrotum). This type mostly affects white men or people designated male at birth (DMAB).

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Symptoms and Causes

What causes angiokeratomas?

Angiokeratomas occur when tissues that support capillary walls lose their elasticity. These can be genetic. This may also be due to vascular malformations, pressure on blood vessels or chronic irritation. The stiffened capillaries swell and may break open.

The same thing happens when you have spider veins. With an angiokeratoma, the enlarged capillary pushes 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 capillaries. This leads to angiokeratoma of the scrotum. In addition, pressure during pregnancy can cause angiokeratoma of the vulva.

Sometimes, a solitary angiokeratoma develops in an injured body area years after a trauma.

What are the symptoms of angiokeratoma?

Angiokeratomas resemble warts. They can appear anywhere on your body. The bumps typically start red and then darken to black or purple with thickened overlying skin. They’re less noticeable on darker skin.

When you press on a lesion, it doesn’t lighten (blanch). You may have one skin lesion (solitary angiokeratoma) or as many as 100 lesions.

Angiokeratomas are:

  • Dome-shaped.
  • Firm or hard to the touch.
  • Red, blue, purple or black.
  • Smaller than a quarter of an inch (5 millimeters).
  • Rough on the surface, with a pebble-like or scaly texture and appearance.

What are the risk factors for angiokeratoma?

Anyone can develop angiokeratomas. Some types are more common among certain ages and sexes.

For instance, white men and people DMAB are more prone to angiokeratoma of the scrotum (Fordyce). People with lysosomal storage disorders are more likely to develop angiokeratoma corporis diffusum.

What are the complications of angiokeratomas?

Some angiokeratomas are more prone to bleeding, even when slightly bumped. And some people find the bumps to be irritating. Other problems include itching or a burning sensation.

Angiokeratomas can develop blood clots. These blood clots aren’t dangerous like the ones that can cut off your body’s blood supply. These clots don’t put you at risk for strokes or heart attacks. But they can be painful.

Diagnosis and Tests

How are angiokeratomas diagnosed?

For a diagnosis, you might see a dermatologist. This medical doctor specializes in diagnosing and treating skin conditions.

While angiokeratomas aren’t skin cancer, some lesions can mimic melanoma. Your healthcare provider may use a microscope device to view the skin lesions more clearly (dermoscopy). You may also need a skin biopsy to rule out cancer.

Management and Treatment

Is there a cure for angiokeratoma?

Angiokeratomas don’t go away on their own. Sometimes, they get bigger and multiply.

Most angiokeratomas don’t need treatment. However, you may choose to get treatment if you feel self-conscious about how they look. Treatment is also an option if the skin lesions bleed, itch or cause other problems.

Treatments take place in your healthcare provider’s office. You may receive a local anesthetic to numb your skin. You should be aware that some treatments for angiokeratomas can cause scarring.

Your healthcare provider may perform one 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.
  • Skin excision to remove the damaged capillary.

Outlook / Prognosis

What is the outlook for people with angiokeratoma?

Angiokeratomas may make you self-conscious about how you look. These feelings can lead to depression or anxiety. Treatments can help you cope with these changes in your appearance. Other treatments may be able to get rid of the lesions.

Many angiokeratomas don’t need any treatment, although a diagnosis is important to rule out more serious conditions.

Living With

What should I ask my provider?

You may want to ask your healthcare provider:

  • What caused the angiokeratomas?
  • What type of angiokeratoma do I have?
  • Do I need treatment?
  • What are my treatment options?
  • Should I look out for signs of complications?

Additional Common Questions

Is an angiokeratoma an STD?

No, angiokeratomas aren’t a sexually transmitted disease or infection (STD or STI). You can’t catch angiokeratomas from someone else. Lesions from angiokeratoma of the scrotum or angiokeratoma of the vulva may resemble genital warts. Your healthcare provider may perform a skin biopsy to make a diagnosis.

Can treated angiokeratomas come back?

Treated angiokeratomas are unlikely to reappear. However, new skin lesions can develop in other places on your body.

Is angiokeratoma a type of skin cancer?

No, angiokeratoma isn’t skin cancer. Having the condition doesn’t increase your cancer risk.

A note from Cleveland Clinic

Angiokeratomas are small, discolored bumps that form when capillaries get bigger or break open and the overlying skin thickens leading to a rough or pebbly appearance. There are different types of angiokeratomas. Angiokeratoma of Fordyce causes bumps on the scrotum or vulva that can resemble genital warts. Talk to your healthcare provider if the skin lesions make you self-conscious about your appearance or if the lesions bleed, itch or cause pain. Treatments can help.

Medically Reviewed

Last reviewed on 06/08/2022.

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