Angiokeratomas are present in approximately 0.16% of the population, with only 14% classified as the Fordyce type. Angiokeratomas of Fordyce are mainly found on the scrotum, with very rare occurrences on the glans penis or penile shaft. Currently, there are no established guidelines in the management of angiokeratomas. Since angiokeratomas are vascular in nature, lasers which target the chromophore oxyhemoglobin can be used, hence the use of the 578-nm yellow laser in this case.

This is a case of a 34-year-old Filipino male with a 22-year history of violaceous papules on the penile shaft gradually increasing in size, with complaints of bleeding from the lesions during coitus, significantly affecting the patient’s quality of life. Physical examination revealed few, well-defined, round, violaceous hyperkeratotic papules on the penile shaft, the largest measuring 4x4x4 mm. Dermoscopy revealed several, well-demarcated, round, erythematous to violaceous lacunae with whitish veil. Histopathology also revealed findings consistent with angiokeratoma.

Non-scrotal or penile angiokeratoma of Fordyce is a very rare benign vascular tumor that can adversely affect patients’ quality of life, particularly due to the potential discomfort brought about by bleeding during coitus. Traditional therapeutic modalities may lead to scarring, hence the emerging trend on the use of vascular lasers. After two sessions of yellow laser, our patient expressed satisfaction with the results with an improved overall quality of life. The effectiveness, minimal scarring potential, and relatively safe side effect profile of these vascular lasers make them a promising treatment option for angiokeratomas.