Dermatology: Practical and Conceptual


306 Letter  |  Dermatol Pract Concept 2019;9(4):14

Dermatology Practical & Conceptual

Introduction

Unilateral nevoid telangiectasia (UNT) is a benign cutane-

ous vascular disorder, first described by Blaschko in 1899, 

characterized by clustered telangiectasias with a reticular 

appearance, blanching with diascopy, and often following 

a dermatomal pattern especially in C3 and C4 dermatomes, 

although there are reported cases without this distribution. 

The pathogenesis is linked mostly to estrogenic action to 

release nitric oxide causing capillary relaxation; this theory 

is supported by the predominance in female teenagers and 

patients with chronic liver disease presenting with this con-

dition; however, the estrogenic role remains unclear because 

of the lack of receptors in skin and normal estrogen and 

progesterone levels in some patients with UNT [1].

Case Presentation

A 13-year-old female patient presented with a 16-month 

history of erythematous reticulated macules (Figure 1), 

sized from 5 mm to 30 mm, affecting the right mammary 

region and posterior right arm, which was asymptomatic and 

appeared a few months after her menarche.

Dermoscopy showed red tortuous capillaries with a retic-

ulated appearance (Figure 2). The lesion blanched completely 

with diascopy. Skin biopsy revealed a normal epidermis and 

Dermoscopy as an Important Tool for 
Differentiating Unilateral Nevoid Telangiectasia 

and Angioma Serpiginosum
Uriel Villela-Segura1

1 Dermatology Department, Hospital Regional Licenciado Adolfo López Mateos ISSSTE, Mexico City, Mexico

Key words: unilateral nevoid telangiectasia, angioma serpiginosum, vascular skin tumors

Citation: Villela-Segura U. Dermoscopy as an important tool for differentiating unilateral nevoid telangiectasia and angioma serpiginosum. 
Dermatol Pract Concept. 2019;9(4):306-307. DOI: https://doi.org/10.5826/dpc.0904a14

Accepted: May 23, 2019; Published: October 31, 2019

Copyright: ©2019 Villela-Segura. This is an open-access article distributed under the terms of the Creative Commons Attribution License, 
which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: None.

Competing interests: The author has no conflicts of interest to disclose.

Authorship: The author takes responsibility for this publication.

Corresponding author: Uriel Villela-Segura, MD, Hospital Regional Licenciado Adolfo López Mateos ISSSTE, Av. Universidad 1321, 
Florida, BO 01030, Delegación Álvaro Obregón, Mexico City, Mexico. Email: uvise08@gmail.com

Figure 1. Red-violaceous reticulated macules. [Copyright: 

©2019 Villela-Segura.]



Letter  |  Dermatol Pract Concept 2019;9(4):14 307

dilated capillaries composed of 1 endothelial layer in the 

papillary dermis (Figure 3). UNT was diagnosed and the 

patient received treatment with Nd:YAG laser, showing a 

good response.

The main clinical differential diagnosis is the angioma ser-

piginosum (AS), which is more common than UNT, appearing 

mostly in young female patients, and whose origin has been 

linked to estrogens as well as a mutation in the PORCN 

gene. Unlike UNT, this entity does not blanch with diascopy 

and in dermoscopy the presence of multiple red oval lagoons 

are characteristic. Histological findings are the same as in 

UNT [2].

Both conditions show excellent response with Nd:YAG 

laser. AS can be treated with a good outcome also with argon 

laser, 532 nm potassium titanyl phosphate laser, and intense 

pulsed light [1].

Conclusions

Dermoscopy is a useful tool to achieve the diagnosis of UNT, 

since red tortuous capillaries in a reticulated pattern are 

distinctive in this entity. These findings help us to differenti-

ate this condition from the AS and to better select the most 

adequate aesthetic treatment.

Figure 3. Dilated capillaries in dermis (H&E, ×20). [Copyright: 

©2019 Villela-Segura.]

Figure 2. (A) Nonmelano-

cytic lesion with red tortuous 

capillaries on dermoscopy. (B) 

Reticular appearance. [Copy-

right: ©2019 Villela-Segura.]

A B

References

1. Wenson SF, Jan F, Sepehr A. Unilateral nevoid telangiectasia syn-

drome: a case report and review of the literature. Dermatol Online 

J. 2011;17(5):2.

2. Ghanadan A, Kamyab-Hesari K, Moslehi H, Abasi A. Dermos-

copy of angioma serpiginosum: a case report. Int J Dermatol. 

2014;53(12):1505-1507.