Petechial angiomata are benign vascular skin tumors, that typically present as flat, irregularly shaped spots ranging from bright red to purple in color, measuring approximately 0.2 to 3 mm in diameter. They are primarily found on the trunk and proximal extremities. We report atypical petechial angiomata with acral involvement in a 75-year-old woman. She had a history of bladder cancer that was treated surgically and had been on raloxifene therapy for osteoporosis for approximately 4 years. Histopathologic finding revealed dilated vascular channels and an enlarged capillary lake within the papillary dermis surrounded by tortuous capillaries. Immunohistochemical analysis showed positivity of CD31 in the entire cell lining, but negativity for D2-40. To our knowledge, acral involvement in petechial angiomata has not been reported previously. Although both the nosology and pathophysiology of this feature remain unclear, endothelial dilation related to long-term raloxifene medication may contribute to the development of atypical vascular lesions.

Petechial angiomata are benign vascular skin tumors, that typically present as flat, irregularly shaped spots ranging from bright red to purple in color, measuring approximately 0.2 to 3 mm in diameter. They are primarily found on the trunk and proximal extremities. We report atypical petechial angiomata with acral involvement in a 75-year-old woman. She had a history of bladder cancer that was treated surgically and had been on raloxifene therapy for osteoporosis for approximately 4 years. Histopathologic finding revealed dilated vascular channels and an enlarged capillary lake within the papillary dermis surrounded by tortuous capillaries. Immunohistochemical analysis showed positivity of CD31 in the entire cell lining, but negativity for D2-40. To our knowledge, acral involvement in petechial angiomata has not been reported previously. Although both the nosology and pathophysiology of this feature remain unclear, endothelial dilation related to long-term raloxifene medication may contribute to the development of atypical vascular lesions.