Córdoba-Fernández Antonio, Jiménez-Cristino María Dolores, Córdoba-Jiménez Victoria Eugenia
Departamento de Podología, Universidad de Sevilla, C/Avicena s/n, 41009 Sevilla, Spain.
Private Practice, C/Dr. Fleming 13, Bajo B, Castilleja de la Cuesta, 41950 Sevilla, Spain.
Dermatopathology (Basel). 2022 Jul 25;9(3):271-276. doi: 10.3390/dermatopathology9030031.
Lobular capillary hemangioma (LCH-PG) is a type of pyogenic granuloma characterized by proliferating blood vessels that resemble conventional granulation tissue. Granulation tissue is very often seen in association with ingrown toenails. Despite the close relationship between both entities, LCH-PG shows clinically different behaviors, such as rapid growth and frequent recurrence. Currently, it is unknown exactly how the different etiological factors contribute to the formation of differences between entities. We present a case of a large LCH-PG associated with chronic onychocryptosis in a 26-year-old man. Histopathological features included extensive signs of ulceration, hyperkeratosis, and patchy epidermal acanthosis with the presence of fibrous septa with lobular areas beneath the ulcerative area. The presence of stroma with a marked proliferation of blood vessels with wall thickening and mixed-type inflammatory changes was also characteristic. In advanced stages of onychocryptosis, as presented here, conventional granulation tissue or pyogenic granuloma can be clinically difficult to distinguish from other benign or malignant neoplasms. Histological examination is mandatory, and excisional biopsy can provide a definitive diagnosis.
小叶状毛细血管瘤（LCH-PG）是一种化脓性肉芽肿，其特征为增殖的血管类似于传统的肉芽组织。肉芽组织常与嵌甲相关。尽管这两种情况关系密切，但LCH-PG表现出不同的临床行为，如生长迅速和频繁复发。目前，尚不清楚不同的病因因素究竟如何导致两者之间形成差异。我们报告一例26岁男性的大型LCH-PG与慢性嵌甲相关。组织病理学特征包括广泛的溃疡、角化过度迹象，以及溃疡区域下方有小叶区域的片状表皮棘皮症伴纤维间隔。伴有血管明显增殖、管壁增厚和混合型炎症改变的间质存在也是其特征。在此处呈现的嵌甲晚期，传统的肉芽组织或化脓性肉芽肿在临床上可能难以与其他良性或恶性肿瘤区分开来。组织学检查是必需的，切除活检可提供明确诊断。
