Abstract
Targetoid Hemosiderotic Hemangioma, also known as Hobnail Hemangioma, is a lesion of vascular origin, probably lymphatic. The most common clinical feature is a solitary violaceous papule surrounded by a pale, thin area and a peripheral ecchymotic ring, simulating a target. Histopathologically, there is a biphasic pattern, with dilated vessels in the superficial dermis and pseudoangiosarcomatous pattern in the deep dermis, and endothelial cells with hobnail morphology. A simple excision is curative. We report a rare case of Targetoid Hemosiderotic Hemangioma.
Hemangioma; Pathology; Vascular diseases
INTRODUCTION
Targetoid Hemosiderotic Hemangioma (THH), also known as Hobnail Hemangioma, is a
vascular, benign solitary lesion of unknown origin, probably lymphatic, which affects
young or middle-aged people.11 Guillou L, Calonje E, Speight P, Rosai J, Fletcher CD. Hobnail
hemangioma: a pseudomalignant vascular lesion with a reappraisal of targetoid
hemosiderotic hemangioma. Am J Surg Pathol. 1999;23:97-105.
2 Sahin MT, Demir MA, Gunduz K, Ozturkcan S, Türel-Ermertcan A. Targetoid
haemosiderotic haemangioma: dermoscopic monitoring of three cases and review of the
literature. Clin Exp Dermatol. 2005;30:672-6.-33 Santa Cruz DJ, Aronberg J. Targetoid hemosiderotic hemangioma. J Am Acad
Dermatol. 1988;19:550-8. The term THH describes the clinical lesion that
presents as a small violaceous papule surrounded by a pale, thin area and a peripheral
ecchymotic ring.33 Santa Cruz DJ, Aronberg J. Targetoid hemosiderotic hemangioma. J Am Acad
Dermatol. 1988;19:550-8. The term Hobnail Hemangioma, on
the other hand, was proposed to describe a histological feature of the lesion: the
hobnail appearance of the endothelial cell. We report a rare case of THH.11 Guillou L, Calonje E, Speight P, Rosai J, Fletcher CD. Hobnail
hemangioma: a pseudomalignant vascular lesion with a reappraisal of targetoid
hemosiderotic hemangioma. Am J Surg Pathol. 1999;23:97-105.
CASE REPORT
A 29-year-old male patient, born and residing in São Paulo-SP, presented violaceous, targetoid lesions consisting of a papular center surrounded by a paler, intermediate area and a peripheral purpuric halo. The lesion measured about 3 x 2 cm, was located on the upper back and had been present for 1 year (Figure 1). An incisional biopsy of the lesion showed angiomatous proliferation in the dermis and nuclear atypia, suggesting a diagnosis of angiokeratoma or Kaposi's sarcoma (Figures 2-6). The diagnosis was made after review of the slide, which showed epidermis with mild acanthosis. In the superficial dermis, dilated vessel proliferation had an aspect compatible with lymphatic capillary, sometimes showing endothelial cells with a hobnail aspect, giving prominence to the lumens. More deeply, vascular spaces become sometimes slit-like, appearing to dissect through collagen bundles. Presence of extravasated erythrocytes and hemosiderin deposits at the periphery of the lesion. These findings, correlated with the clinical feature of targetoid lesion, allowed us to make the diagnosis of THH. The patient opted for a total removal of the lesion.
Violaceous, targetoid lesion consisting of a papular center surrounded by a paler, intermediate area and a peripheral purpuric halo on the upper back
100x. Dermal angiomatous proliferation with dilated vessels in the superficial dermis and dissecting collagen bundles in the middle and deep dermis
400x. Peripheral area of the lesion with intense red blood cell extravasation and hemosiderin deposition
DISCUSSION
THH was first described in 1988.33 Santa Cruz DJ, Aronberg J. Targetoid hemosiderotic hemangioma. J Am Acad
Dermatol. 1988;19:550-8. Classically, it
presents as a single, small, red-violaceous to brown targetoid lesion, surrounded by a
hemorrhagic halo in the acute phase, and which can expand centrifugally. In later
stages, the halo may disappear, leaving only the central papule.22 Sahin MT, Demir MA, Gunduz K, Ozturkcan S, Türel-Ermertcan A. Targetoid
haemosiderotic haemangioma: dermoscopic monitoring of three cases and review of the
literature. Clin Exp Dermatol. 2005;30:672-6.
3 Santa Cruz DJ, Aronberg J. Targetoid hemosiderotic hemangioma. J Am Acad
Dermatol. 1988;19:550-8.
4 Al Dhaybi R, Lam C, Hatami A, Powell J, McCuaig C, Kokta V. Targetoid
hemosiderotic hemangiomas (hobnail hemangiomas) are vascular lymphatic malformations:
a study of 12 pediatric cases. J Am Acad Dermatol. 2012;66:116-20.-55 Carlson JA, Daulat S, Goodheart HP. Targetoid hemosiderotic hemangioma-
a dynamic vascular tumor: report of 3 cases with episodic and cyclic changes and
comparison with solitary angiokeratomas. J Am Acad Dermatol.
1999;41:215-24. Some cases
without targetoid formation have been reported.55 Carlson JA, Daulat S, Goodheart HP. Targetoid hemosiderotic hemangioma-
a dynamic vascular tumor: report of 3 cases with episodic and cyclic changes and
comparison with solitary angiokeratomas. J Am Acad Dermatol.
1999;41:215-24.
Young or middle aged individuals are more affected.22 Sahin MT, Demir MA, Gunduz K, Ozturkcan S, Türel-Ermertcan A. Targetoid
haemosiderotic haemangioma: dermoscopic monitoring of three cases and review of the
literature. Clin Exp Dermatol. 2005;30:672-6.,44 Al Dhaybi R, Lam C, Hatami A, Powell J, McCuaig C, Kokta V. Targetoid
hemosiderotic hemangiomas (hobnail hemangiomas) are vascular lymphatic malformations:
a study of 12 pediatric cases. J Am Acad Dermatol. 2012;66:116-20.
5 Carlson JA, Daulat S, Goodheart HP. Targetoid hemosiderotic hemangioma-
a dynamic vascular tumor: report of 3 cases with episodic and cyclic changes and
comparison with solitary angiokeratomas. J Am Acad Dermatol.
1999;41:215-24.
6 Franke FE, Steger K, Marks A, Kutzner H, Mentzel T. Hobnail hemangiomas
(targetoid hemosiderotic hemangiomas) are true lymphangiomas. J Cutan Pathol.
2004;31:362-7.-77 Trindade F, Kutzner H, Tellechea Ó, Requena L, Colmenero I. Hobnail
hemangioma reclassified as superficial lymphatic malformation: a study of 52 cases. J
Am Acad Dermatol. 2012;66:112-5. There is no gender predominance.55 Carlson JA, Daulat S, Goodheart HP. Targetoid hemosiderotic hemangioma-
a dynamic vascular tumor: report of 3 cases with episodic and cyclic changes and
comparison with solitary angiokeratomas. J Am Acad Dermatol.
1999;41:215-24. It is preferably located on the trunk or
extremities.22 Sahin MT, Demir MA, Gunduz K, Ozturkcan S, Türel-Ermertcan A. Targetoid
haemosiderotic haemangioma: dermoscopic monitoring of three cases and review of the
literature. Clin Exp Dermatol. 2005;30:672-6.,44 Al Dhaybi R, Lam C, Hatami A, Powell J, McCuaig C, Kokta V. Targetoid
hemosiderotic hemangiomas (hobnail hemangiomas) are vascular lymphatic malformations:
a study of 12 pediatric cases. J Am Acad Dermatol. 2012;66:116-20.
5 Carlson JA, Daulat S, Goodheart HP. Targetoid hemosiderotic hemangioma-
a dynamic vascular tumor: report of 3 cases with episodic and cyclic changes and
comparison with solitary angiokeratomas. J Am Acad Dermatol.
1999;41:215-24.
6 Franke FE, Steger K, Marks A, Kutzner H, Mentzel T. Hobnail hemangiomas
(targetoid hemosiderotic hemangiomas) are true lymphangiomas. J Cutan Pathol.
2004;31:362-7.-77 Trindade F, Kutzner H, Tellechea Ó, Requena L, Colmenero I. Hobnail
hemangioma reclassified as superficial lymphatic malformation: a study of 52 cases. J
Am Acad Dermatol. 2012;66:112-5.
The wide variation in clinical appearance, especially in coloration, explains why this
lesion may be clinically confused with hemangioma, dermatofibroma, reaction to insect
sting, Kaposi's sarcoma, melanocytic nevus and melanoma.22 Sahin MT, Demir MA, Gunduz K, Ozturkcan S, Türel-Ermertcan A. Targetoid
haemosiderotic haemangioma: dermoscopic monitoring of three cases and review of the
literature. Clin Exp Dermatol. 2005;30:672-6.
3 Santa Cruz DJ, Aronberg J. Targetoid hemosiderotic hemangioma. J Am Acad
Dermatol. 1988;19:550-8.
4 Al Dhaybi R, Lam C, Hatami A, Powell J, McCuaig C, Kokta V. Targetoid
hemosiderotic hemangiomas (hobnail hemangiomas) are vascular lymphatic malformations:
a study of 12 pediatric cases. J Am Acad Dermatol. 2012;66:116-20.-55 Carlson JA, Daulat S, Goodheart HP. Targetoid hemosiderotic hemangioma-
a dynamic vascular tumor: report of 3 cases with episodic and cyclic changes and
comparison with solitary angiokeratomas. J Am Acad Dermatol.
1999;41:215-24. In these cases,
dermoscopy is a useful tool that can aid in the differentiation of melanocytic lesions.
Dermoscopy shows well-demarcated red or red-bluish lakes (depending on the extent of
involvement in the dermis). Black macules may also be seen and represent hemorrhagic
crusts.22 Sahin MT, Demir MA, Gunduz K, Ozturkcan S, Türel-Ermertcan A. Targetoid
haemosiderotic haemangioma: dermoscopic monitoring of three cases and review of the
literature. Clin Exp Dermatol. 2005;30:672-6.
The exact pathogenesis of THH is unknown, although it has been postulated that trauma is one of the main causes for the targetoid appearance.33 Santa Cruz DJ, Aronberg J. Targetoid hemosiderotic hemangioma. J Am Acad Dermatol. 1988;19:550-8.,55 Carlson JA, Daulat S, Goodheart HP. Targetoid hemosiderotic hemangioma- a dynamic vascular tumor: report of 3 cases with episodic and cyclic changes and comparison with solitary angiokeratomas. J Am Acad Dermatol. 1999;41:215-24.,77 Trindade F, Kutzner H, Tellechea Ó, Requena L, Colmenero I. Hobnail hemangioma reclassified as superficial lymphatic malformation: a study of 52 cases. J Am Acad Dermatol. 2012;66:112-5.,88 Christenson LJ, Stone MS. Trauma-induced simulator of targetoid hemosiderotic hemangioma. Am J Dermatopathol. 2001;23:221-3. Trauma could lead to the development of microshunts, in which the pressure of the capillaries would cause the filling of the lymph spaces of the lesion with erythrocytes, and contribute to the formation of aneurysmal microstructures.66 Franke FE, Steger K, Marks A, Kutzner H, Mentzel T. Hobnail hemangiomas (targetoid hemosiderotic hemangiomas) are true lymphangiomas. J Cutan Pathol. 2004;31:362-7. The obstruction of some efferent lymphatic vessels would result in inflammation, fibrosis and interstitial hemosiderin deposits.66 Franke FE, Steger K, Marks A, Kutzner H, Mentzel T. Hobnail hemangiomas (targetoid hemosiderotic hemangiomas) are true lymphangiomas. J Cutan Pathol. 2004;31:362-7.,77 Trindade F, Kutzner H, Tellechea Ó, Requena L, Colmenero I. Hobnail hemangioma reclassified as superficial lymphatic malformation: a study of 52 cases. J Am Acad Dermatol. 2012;66:112-5. Hormones may also potentiate these tumors.99 Ortiz-Rey JA, González-Ruiz A, San Miguel P, Alvarez C, Iglesias B, Antón I. Hobnail haemangioma associated with the menstrual cycle. J Eur Acad Dermatol Venereol. 2005;19:367-9.
Histology varies according to the developmental stage in which the lesion was biopsied.11 Guillou L, Calonje E, Speight P, Rosai J, Fletcher CD. Hobnail hemangioma: a pseudomalignant vascular lesion with a reappraisal of targetoid hemosiderotic hemangioma. Am J Surg Pathol. 1999;23:97-105.,33 Santa Cruz DJ, Aronberg J. Targetoid hemosiderotic hemangioma. J Am Acad Dermatol. 1988;19:550-8.,1010 Mentzel T, Partanen TA, Kutzner H. Hobnail hemangioma ("targetoid hemosiderotic hemangioma"): clinicopathologic and immunohistochemical analysis of 62 cases . J Cutan Pathol. 1999;26:279-86. In the initial stages, there is a biphasic pattern: in the papillary dermis, there are dilated vessels lined by a single layer of prominent epithelioid-like endothelial cells with solid intraluminal projections and hobnail appearance; and in the deep dermis, the vascular spaces are angulated and slit-like, resembling lymphatic vessels, which are concentrated around sweat glands, often forming small hemangiomatous nodules, dissecting the collagen bundles.33 Santa Cruz DJ, Aronberg J. Targetoid hemosiderotic hemangioma. J Am Acad Dermatol. 1988;19:550-8.,1010 Mentzel T, Partanen TA, Kutzner H. Hobnail hemangioma ("targetoid hemosiderotic hemangioma"): clinicopathologic and immunohistochemical analysis of 62 cases . J Cutan Pathol. 1999;26:279-86. Extensive extravasation of red blood cells, inflammatory lymphocytic aggregates and fibrin thrombi are present.33 Santa Cruz DJ, Aronberg J. Targetoid hemosiderotic hemangioma. J Am Acad Dermatol. 1988;19:550-8.,44 Al Dhaybi R, Lam C, Hatami A, Powell J, McCuaig C, Kokta V. Targetoid hemosiderotic hemangiomas (hobnail hemangiomas) are vascular lymphatic malformations: a study of 12 pediatric cases. J Am Acad Dermatol. 2012;66:116-20.,1010 Mentzel T, Partanen TA, Kutzner H. Hobnail hemangioma ("targetoid hemosiderotic hemangioma"): clinicopathologic and immunohistochemical analysis of 62 cases . J Cutan Pathol. 1999;26:279-86. In later stages, the vascular lumen appears collapsed and there is extensive deposition of hemosiderin in the stroma, as well as fibrosis.33 Santa Cruz DJ, Aronberg J. Targetoid hemosiderotic hemangioma. J Am Acad Dermatol. 1988;19:550-8.,44 Al Dhaybi R, Lam C, Hatami A, Powell J, McCuaig C, Kokta V. Targetoid hemosiderotic hemangiomas (hobnail hemangiomas) are vascular lymphatic malformations: a study of 12 pediatric cases. J Am Acad Dermatol. 2012;66:116-20.
THH is a rare, benign entity that may histologically mimic malignancy, as shown in Figures 3 and 4. Dermal angiomatous proliferation with dilated vessels in the superficial dermis simulates angiokeratoma.55 Carlson JA, Daulat S, Goodheart HP. Targetoid hemosiderotic hemangioma- a dynamic vascular tumor: report of 3 cases with episodic and cyclic changes and comparison with solitary angiokeratomas. J Am Acad Dermatol. 1999;41:215-24. Vessels that dissect collagen bundles, extravasated erythrocytes and hemosiderin deposits simulate Kaposi's sarcoma.33 Santa Cruz DJ, Aronberg J. Targetoid hemosiderotic hemangioma. J Am Acad Dermatol. 1988;19:550-8.,44 Al Dhaybi R, Lam C, Hatami A, Powell J, McCuaig C, Kokta V. Targetoid hemosiderotic hemangiomas (hobnail hemangiomas) are vascular lymphatic malformations: a study of 12 pediatric cases. J Am Acad Dermatol. 2012;66:116-20.,55 Carlson JA, Daulat S, Goodheart HP. Targetoid hemosiderotic hemangioma- a dynamic vascular tumor: report of 3 cases with episodic and cyclic changes and comparison with solitary angiokeratomas. J Am Acad Dermatol. 1999;41:215-24.,1010 Mentzel T, Partanen TA, Kutzner H. Hobnail hemangioma ("targetoid hemosiderotic hemangioma"): clinicopathologic and immunohistochemical analysis of 62 cases . J Cutan Pathol. 1999;26:279-86.
It has been found that other vascular lesions may cytomorphologically have endothelial hobnail features, but not the targetoid clinical feature. In order to cover all these forms, the term Hobnail Hemangioma was proposed. Besides the THH, retiform hemangioendothelioma (considered a low-grade malignancy angiosarcoma), Dabska tumor (malignant endovascular papillary angioendothelioma) and progressive lymphangioma also belong to this group.66 Franke FE, Steger K, Marks A, Kutzner H, Mentzel T. Hobnail hemangiomas (targetoid hemosiderotic hemangiomas) are true lymphangiomas. J Cutan Pathol. 2004;31:362-7.,1010 Mentzel T, Partanen TA, Kutzner H. Hobnail hemangioma ("targetoid hemosiderotic hemangioma"): clinicopathologic and immunohistochemical analysis of 62 cases . J Cutan Pathol. 1999;26:279-86. This aspect may also be seen focally in skin or soft tissue angiosarcoma, polymorphic hemangioendothelioma and atypical vascular lesions after radiotherapy.1010 Mentzel T, Partanen TA, Kutzner H. Hobnail hemangioma ("targetoid hemosiderotic hemangioma"): clinicopathologic and immunohistochemical analysis of 62 cases . J Cutan Pathol. 1999;26:279-86.
In contrast to its well-characterized histology, it is unclear whether this tumor arises from endothelial cells of blood vessels or from endothelial cells of lymphatic vessels.77 Trindade F, Kutzner H, Tellechea Ó, Requena L, Colmenero I. Hobnail hemangioma reclassified as superficial lymphatic malformation: a study of 52 cases. J Am Acad Dermatol. 2012;66:112-5. Immunohistochemical studies strongly favor the second hypothesis.44 Al Dhaybi R, Lam C, Hatami A, Powell J, McCuaig C, Kokta V. Targetoid hemosiderotic hemangiomas (hobnail hemangiomas) are vascular lymphatic malformations: a study of 12 pediatric cases. J Am Acad Dermatol. 2012;66:116-20.,66 Franke FE, Steger K, Marks A, Kutzner H, Mentzel T. Hobnail hemangiomas (targetoid hemosiderotic hemangiomas) are true lymphangiomas. J Cutan Pathol. 2004;31:362-7.,77 Trindade F, Kutzner H, Tellechea Ó, Requena L, Colmenero I. Hobnail hemangioma reclassified as superficial lymphatic malformation: a study of 52 cases. J Am Acad Dermatol. 2012;66:112-5.,1010 Mentzel T, Partanen TA, Kutzner H. Hobnail hemangioma ("targetoid hemosiderotic hemangioma"): clinicopathologic and immunohistochemical analysis of 62 cases . J Cutan Pathol. 1999;26:279-86. There is positivity for CD31 (considered a pan-endothelial marker) and VEGFR-3 (vascular endothelial growth factor receptor-3, which is a specific marker for lymphatic endothelial cells), whereas only few or no cells are positive for CD34.66 Franke FE, Steger K, Marks A, Kutzner H, Mentzel T. Hobnail hemangiomas (targetoid hemosiderotic hemangiomas) are true lymphangiomas. J Cutan Pathol. 2004;31:362-7.,1010 Mentzel T, Partanen TA, Kutzner H. Hobnail hemangioma ("targetoid hemosiderotic hemangioma"): clinicopathologic and immunohistochemical analysis of 62 cases . J Cutan Pathol. 1999;26:279-86. Although CD34 does not differentiate between endothelial cells of blood vessels and endothelial cells of lymphatic vessels, the latter are usually negative or weakly positive for this marker.1010 Mentzel T, Partanen TA, Kutzner H. Hobnail hemangioma ("targetoid hemosiderotic hemangioma"): clinicopathologic and immunohistochemical analysis of 62 cases . J Cutan Pathol. 1999;26:279-86. Furthermore, there are studies that show positive results for D2-40, which is a monoclonal antibody against human podoplanin (mucoprotein expressed in lymphatic endothelial cells).66 Franke FE, Steger K, Marks A, Kutzner H, Mentzel T. Hobnail hemangiomas (targetoid hemosiderotic hemangiomas) are true lymphangiomas. J Cutan Pathol. 2004;31:362-7. Some markers of cell proliferation have also been investigated, such as Ki-67 and WT1 (Wilms' tumor 1) and are little or not expressed.44 Al Dhaybi R, Lam C, Hatami A, Powell J, McCuaig C, Kokta V. Targetoid hemosiderotic hemangiomas (hobnail hemangiomas) are vascular lymphatic malformations: a study of 12 pediatric cases. J Am Acad Dermatol. 2012;66:116-20. This leads to the question whether hobnail hemangioma should not be considered a malformation rather than a tumor.44 Al Dhaybi R, Lam C, Hatami A, Powell J, McCuaig C, Kokta V. Targetoid hemosiderotic hemangiomas (hobnail hemangiomas) are vascular lymphatic malformations: a study of 12 pediatric cases. J Am Acad Dermatol. 2012;66:116-20.,77 Trindade F, Kutzner H, Tellechea Ó, Requena L, Colmenero I. Hobnail hemangioma reclassified as superficial lymphatic malformation: a study of 52 cases. J Am Acad Dermatol. 2012;66:112-5.
Diagnosis is based on clinical-pathological correlation, especially of the typical morphology of the lesion.
Simple excision is curative and allows a correct histological diagnosis.11 Guillou L, Calonje E, Speight P, Rosai J, Fletcher CD. Hobnail hemangioma: a pseudomalignant vascular lesion with a reappraisal of targetoid hemosiderotic hemangioma. Am J Surg Pathol. 1999;23:97-105.,44 Al Dhaybi R, Lam C, Hatami A, Powell J, McCuaig C, Kokta V. Targetoid hemosiderotic hemangiomas (hobnail hemangiomas) are vascular lymphatic malformations: a study of 12 pediatric cases. J Am Acad Dermatol. 2012;66:116-20. Because it is a benign condition, such lesions are only removed for diagnostic or cosmetic reasons, since literature reports clearly indicate that neither local invasion nor dissemination take place. There are no reports of recurrence after excision of the lesion.44 Al Dhaybi R, Lam C, Hatami A, Powell J, McCuaig C, Kokta V. Targetoid hemosiderotic hemangiomas (hobnail hemangiomas) are vascular lymphatic malformations: a study of 12 pediatric cases. J Am Acad Dermatol. 2012;66:116-20.
References
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1Guillou L, Calonje E, Speight P, Rosai J, Fletcher CD. Hobnail hemangioma: a pseudomalignant vascular lesion with a reappraisal of targetoid hemosiderotic hemangioma. Am J Surg Pathol. 1999;23:97-105.
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2Sahin MT, Demir MA, Gunduz K, Ozturkcan S, Türel-Ermertcan A. Targetoid haemosiderotic haemangioma: dermoscopic monitoring of three cases and review of the literature. Clin Exp Dermatol. 2005;30:672-6.
-
3Santa Cruz DJ, Aronberg J. Targetoid hemosiderotic hemangioma. J Am Acad Dermatol. 1988;19:550-8.
-
4Al Dhaybi R, Lam C, Hatami A, Powell J, McCuaig C, Kokta V. Targetoid hemosiderotic hemangiomas (hobnail hemangiomas) are vascular lymphatic malformations: a study of 12 pediatric cases. J Am Acad Dermatol. 2012;66:116-20.
-
5Carlson JA, Daulat S, Goodheart HP. Targetoid hemosiderotic hemangioma- a dynamic vascular tumor: report of 3 cases with episodic and cyclic changes and comparison with solitary angiokeratomas. J Am Acad Dermatol. 1999;41:215-24.
-
6Franke FE, Steger K, Marks A, Kutzner H, Mentzel T. Hobnail hemangiomas (targetoid hemosiderotic hemangiomas) are true lymphangiomas. J Cutan Pathol. 2004;31:362-7.
-
7Trindade F, Kutzner H, Tellechea Ó, Requena L, Colmenero I. Hobnail hemangioma reclassified as superficial lymphatic malformation: a study of 52 cases. J Am Acad Dermatol. 2012;66:112-5.
-
8Christenson LJ, Stone MS. Trauma-induced simulator of targetoid hemosiderotic hemangioma. Am J Dermatopathol. 2001;23:221-3.
-
9Ortiz-Rey JA, González-Ruiz A, San Miguel P, Alvarez C, Iglesias B, Antón I. Hobnail haemangioma associated with the menstrual cycle. J Eur Acad Dermatol Venereol. 2005;19:367-9.
-
10Mentzel T, Partanen TA, Kutzner H. Hobnail hemangioma ("targetoid hemosiderotic hemangioma"): clinicopathologic and immunohistochemical analysis of 62 cases . J Cutan Pathol. 1999;26:279-86.
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Financial funding: None
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How to cite this article: Kakizaki P, Valente NYS, Paiva DLM, Dantas FLT, Gonçalves SVCB. Targetoid hemosiderotic hemangioma - Case report. An Bras Dermatol. 2014;89(6):956-9.
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*
Study conducted at the São Paulo Hospital for State Civil Servants - São Paulo (SP), Brazil.
Publication Dates
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Publication in this collection
Nov-Dec 2014
History
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Received
12 Nov 2013 -
Accepted
30 Dec 2013