Benign Angioma

A 36-year-old woman notes the insidious onset of an asymptomatic lesion located on the scalp. Despite frequently hitting it with a comb or brush, it has never bled. The patient is ostensibly in good health.

Key point: This smooth surfaced, red-purple 4-mm papule appears to clearly be vascular in nature. The lack of friability makes the diagnosis of pyogenic granuloma unlikely. While some cutaneous metastases are typically vascular-appearing, especially renal cell carcinoma, the patient is too young for that diagnosis to be highly considered. Simple removal is indicated, but histological examination remains mandatory.

Treatment: A shave excision was done, followed by light electrocautery to the base. Pathology revealed a benign angioma.

Note: Excision would have been more difficult and possibly led to some degree of postoperative alopecia. Thus, a more conservative method was used to remove the lesion.