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Case Reports
. 2015 Jul 29;7(2):194-8.
doi: 10.1159/000438664. eCollection 2015 May-Aug.

Blue Rubber Bleb Nevus Syndrome Showing Vascular Skin Lesions Predominantly on the Face

Ayumi Korekawa  1 , Koji Nakajima  1 , Takayuki Aizu  1 , Hajime Nakano  1 , Daisuke Sawamura  1
Affiliations
Case Reports

Blue Rubber Bleb Nevus Syndrome Showing Vascular Skin Lesions Predominantly on the Face

Ayumi Korekawa et al. Case Rep Dermatol. .

Abstract

An 81-year-old Japanese man presented with dark blue papules and nodules on his face. There were multiple soft papules and nodules, dark blue in color, compressive, and ranging in size from 2 to 10 mm. A few similar lesions were seen on the patient's right dorsal second toe and right buccal mucosa. There were no skin lesions on his trunk and upper limbs. The patient's past history did not include gastrointestinal bleeding or anemia. Histopathological examination showed dilated vascular spaces lined by the normal epithelium extending beneath the dermis and into the subcutaneous fat. Endoscopy of the gastrointestinal tract to check for colon involvement was not performed. X-ray images of the limbs revealed no abnormalities in the bones or joints. Laboratory investigations did not show anemia. Although we failed to confirm a diagnosis by endoscopy, the skin lesions, histopathological findings, lack of abnormal X-ray findings, and the presence of oral lesions as a part of gastrointestinal tract guided the diagnosis of blue rubber bleb nevus syndrome (BRBNS). Skin lesions of BRBNS occur predominantly on the trunk and upper limbs. However, the present case showed multiple skin lesions predominantly on the face. Therefore, it is important for clinicians to know about a possible atypical distribution of skin lesions in BRBNS.

Keywords: Gastrointestinal bleeding; Lower leg; Trauma; Venous malformation.

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Figures

Fig. 1
Fig. 1
Multiple, dark blue, compressive papules and nodules on the patient's face, ranging in size from 2 to 10 mm.
Fig. 2
Fig. 2
Dark blue and compressive papules on the patient's right dorsal second toe (bottom) and buccal mucosa (top).
Fig. 3
Fig. 3
a Dilated vascular spaces lined by normal epithelium in the dermis. b, c The vascular space is surrounded by thin connective tissue. Lysed erythrocytes were observed within the vascular space. Hematoxylin and eosin staining. a Whole picture. b ×40. c ×400.
See this image and copyright information in PMC

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