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Journal of the American Academy of Dermatology
Volume 48, n° 2S
pages 15-17 (février 2003)
Doi : 10.1067/mjd.2003.127
Linear acral pseudolymphomatous angiokeratoma of children (APACHE): Further evidence that APACHE is a cutaneous pseudolymphoma

Takahiro Kiyohara, MDa, Masanobu Kumakiri, MDa, Takeo Kawasaki, MDa, Akiteru Takeuchi, MDb, Hiroaki Kuwahara, MDb, Takanori Ueda, MDc
Fukui, Japan 
From the Department of Dermatology,a the Division of Plastic Surgery,b and the 1st Department of Internal Medicine,c Fukui Medical University 


Acral pseudolymphomatous angiokeratoma of children (APACHE) is a recently recognized, rare clinical entity. We report a case of APACHE in a 9-year-old Japanese girl with a dark red, linear plaque on the posterior area of the right lower leg. Histopathologic findings revealed further evidence that APACHE was a cutaneous pseudolymphoma rather than a vascular neoplasm because of the presence of distinct primary and secondary lymphoid follicles, and thick-walled, long blood vessels lined with prominent plump endothelial cells similar to high endothelial venules in the paracortical area of the lymph node. In addition to previous descriptions, the patient presented with a distinct linear lesion. Vacuolar alteration of the basal cell layer and scattered eosinophilic bodies in the epidermis were observed, which suggested a lichenoid tissue reaction. We believe that APACHE might show a distinct linear pattern accompanied by a lichenoid tissue reaction. (J Am Acad Dermatol 2003;48:S15-7.)

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 This supplement is made possible through an unrestricted educational grant from Stiefel Laboratories to the American Academy of Dermatology.
 Reprint requests: Takahiro Kiyohara, Department of Dermatology, Fukui Medical University, 23-3 Shimoaizuki, Matsuoka-cho, Yoshida-gun, Fukui 910-1193, Japan. E-mail:
 0190-9622/2003/$30.00 + 0

© 2003  American Academy of Dermatology, Inc. Published by Elsevier Masson SAS@@#104157@@