INTRODUCTION
Cutaneous collagenous vasculopathy (CCV) is a rare, idiopathic, cutaneous microangiopathy first reported in the early 2000s.1 It presents as diffuse telangiectasias, initially appearing on the lower extremities, and sometimes spreading to the trunk and upper extremities without nail, mucosal, or systemic involvement.4 Clinically, this differentiates CCV from a similar entity, generalized essential telangiectasia (GET), which presents with a more widespread distribution of telangiectasias, sometimes involving the conjunctiva and oral mucosa. GET is further differentiated from CCV based on histopathologic findings.4 Effective treatment options for CCV are limited. Pulsed dye lasers (PDL) emit visible light at wavelengths of 585 nm and 595 nm and are shown to be safe and effective in the treatment of a variety of cutaneous vascular lesions via the principle of selective photothermolysis.4 Herein, we report 2 cases of CCV successfully treated with PDL therapy and review the existing literature on this topic to suggest optimal laser settings for the treatment of CCV.
CASES
Case One
A 44-year-old woman with Fitzpatrick type II skin and a history of right peroneal deep vein thrombosis presented with a 14-year history of "spider veins" on her bilateral feet, ankles, and legs. She reported that the lesions developed during pregnancy and had worsened over the past several years. She was originally evaluated by vascular surgery. She did not have significant superficial or deep venous reflux. Sclerotherapy and laser therapy for the cosmetic treatment of spider veins were discussed. Given the location of lesions on the ankles and below, she was encouraged to explore laser therapy and was referred to dermatology.
Examination of the lower extremities revealed diffuse violaceous blanchable telangiectasias coalescing into patches along the lateral feet, lateral and medial malleoli, and posterior ankles (Figure 1A and 1C). A biopsy was not performed due to our high clinical suspicion of CCV and to preserve cosmesis. The patient elected to proceed with PDL treatment of the lesions.
A 44-year-old woman with Fitzpatrick type II skin and a history of right peroneal deep vein thrombosis presented with a 14-year history of "spider veins" on her bilateral feet, ankles, and legs. She reported that the lesions developed during pregnancy and had worsened over the past several years. She was originally evaluated by vascular surgery. She did not have significant superficial or deep venous reflux. Sclerotherapy and laser therapy for the cosmetic treatment of spider veins were discussed. Given the location of lesions on the ankles and below, she was encouraged to explore laser therapy and was referred to dermatology.
Examination of the lower extremities revealed diffuse violaceous blanchable telangiectasias coalescing into patches along the lateral feet, lateral and medial malleoli, and posterior ankles (Figure 1A and 1C). A biopsy was not performed due to our high clinical suspicion of CCV and to preserve cosmesis. The patient elected to proceed with PDL treatment of the lesions.
