Cohen Philip R, Celano Nicholas J
San Diego Family Dermatology, National City, CA, USA.
Touro University California College of Osteopathic Medicine, Vallejo, CA, USA.
Dermatol Ther (Heidelb). 2020 Aug;10(4):551-567. doi: 10.1007/s13555-020-00399-3. Epub 2020 Jun 6.
Angiokeratomas are benign vascular lesions. Genital angiokeratomas, also referred to as Fordyce angiokeratomas, usually occur on the scrotum in men and the vulva in women. Penile angiokeratoma (PEAKER) is a subtype of genital angiokeratoma in men; clitoral angiokeratoma (CLANKER) is its embryologic analog in women. The PubMed database was used to search the following words: angiokeratoma, clitoris, genital, peaker, penile, penis, rejuvenation, scrotal, scrotum and vulva. The relevant papers and references cited in those papers that were generated by the search were reviewed. The purpose of this article is to summarize the features of PEAKERs. PEAKERs have been described in 54 men. They usually appeared in younger men and had been present for a mean duration of 4 years prior to the individual seeking medical attention. Only 39% of the men had angiokeratoma-associated symptoms: usually bleeding and increasing size and less often abrupt onset, pain and pruritus. The glans penis (55.5%) and the penile shaft (35%) were the most common sites of PEAKERs; the angiokeratomas were also located on the foreskin (5.5%) or both the glans penis and penile shaft (4%). Thirty seven percent of patients with glans penis PEAKERs only had angiokeratomas on the corona. Scrotal angiokeratomas were also present in 20% of patients with PEAKERs. A solitary PEAKER was observed in 32% of the men. Most of the PEAKERs were 1-5 mm in size. The PEAKERs presented as purple, red and/or blue papules; 70% of the men's PEAKERs were more than one color. Clinical features often established the diagnosis; in addition, some of the men's angiokeratomas were biopsied or evaluated with dermoscopy. Laser therapy, in 56% of the men, was the most common treatment modality. Less common interventions included electrocautery, radiofrequency and excision. PEAKER recurrence or persistence was observed after excision (two men) or cryotherapy (one man), respectively. Several of the men (27%) decided to observe their PEAKERs without treatment.
血管角皮瘤是一种良性血管病变。生殖器血管角皮瘤，也被称为福代斯血管角皮瘤，通常发生在男性的阴囊和女性的外阴。阴茎血管角皮瘤（PEAKER）是男性生殖器血管角皮瘤的一种亚型；阴蒂血管角皮瘤（CLANKER）是女性相应的胚胎学类似物。利用PubMed数据库搜索了以下词汇：血管角皮瘤、阴蒂、生殖器、PEAKER、阴茎、阴茎体、年轻化、阴囊、阴囊和外阴。对搜索产生的相关论文以及这些论文中引用的参考文献进行了综述。本文的目的是总结阴茎血管角皮瘤的特征。已在54名男性中描述了阴茎血管角皮瘤。它们通常出现在较年轻的男性身上，在患者寻求医疗关注之前平均已存在4年。只有39%的男性有与血管角皮瘤相关的症状：通常是出血和增大，较少见的是突然发作、疼痛和瘙痒。阴茎头（55.5%）和阴茎体（35%）是阴茎血管角皮瘤最常见的部位；血管角皮瘤也位于包皮（5.5%）或阴茎头和阴茎体两者（4%）。37%的阴茎头血管角皮瘤患者仅在冠状沟有血管角皮瘤。20%的阴茎血管角皮瘤患者也有阴囊血管角皮瘤。32%的男性观察到单个阴茎血管角皮瘤。大多数阴茎血管角皮瘤大小为1 - 5毫米。阴茎血管角皮瘤表现为紫色、红色和/或蓝色丘疹；70%男性的阴茎血管角皮瘤不止一种颜色。临床特征通常可确立诊断；此外，一些男性的血管角皮瘤进行了活检或皮肤镜检查。56%的男性中，激光治疗是最常见的治疗方式。较不常见的干预措施包括电灼、射频和切除。分别在切除（两名男性）或冷冻治疗（一名男性）后观察到阴茎血管角皮瘤复发或持续存在。有几名男性（27%）决定不治疗而观察他们的阴茎血管角皮瘤。
