A 12-year-old girl presented for evaluation of cutaneous lesions (Fig. 1). She reported having these lesions since birth. They consisted of several plaques located on the dorsum of the left foot. There was a larger plaque, approximately 3 × 2 cm in size, on the pedal region, a smaller one on the dorsum of the first metatarsophalangeal joint, and two smaller subcentimetre-sized papules in between. The lesions had an erythematous base with a hyperkeratotic surface. Clinically, they were asymptomatic. There were no other mucocutaneous lesions or systemic symptoms. Congenital angiokeratoma was suspected, and the patient and her parents reassured. An annual follow-up plan was established, and the patient remained asymptomatic on entering adulthood.
Congenital angiokeratoma is a rare cutaneous vascular malformation that is present from birth or develops in early childhood. It is characterized by the appearance of erythematous plaques with a hyperkeratotic surface. In most instances, it occurs in isolation.1 Recognition of this condition by healthcare providers is crucial to avoid invasive procedures, given its benign nature. However, it is equally important to be aware that the presence of multiple angiokeratomas in a child warrants investigation to rule out Fabry disease.1,2
