Angiokeratoma of Fordyce is the most common type of angiokeratoma, presenting as benign spots in the genital area. These lesions are neither contagious, sexually transmitted, nor cancerous. They typically affect males aged 50 and older but can occur in anyone. The spots are caused by dilated blood vessels near the skin’s surface and appear dark red to purple or black. While usually asymptomatic, some individuals may experience itching or discomfort, and the spots can bleed if traumatized. Diagnosis is made through visual examination. Though treatment is often unnecessary, it may be pursued for cosmetic reasons or to address troublesome bleeding. The condition does not resolve on its own and can grow in number over time. The prognosis is excellent, as the condition is not serious, though lesions may recur after treatment.
Quick Overview
Symptoms
Angiokeratoma of Fordyce presents as dark red, purple, or black spots in the genital area, most commonly on the scrotum or vulva. The lesions are typically 1-5mm but can become large enough to resemble warts, appearing individually or in clusters with visible capillaries. Most patients experience no discomfort, though some may feel warmth and itching. The spots tend to bleed if cut or traumatised. If caused by an underlying condition like Fabry disease, symptoms may include limb pain, tinnitus, lack of sweat, cloudy vision, or abdominal pain.
Causes
The condition occurs when blood vessels near the skin’s surface dilate or break. A common cause is the loss of elasticity in the supporting tissue surrounding capillary walls. Angiokeratoma of Fordyce is not a sexually transmitted infection and is not contagious.
Diagnosis
A diagnosis is typically made by a clinician through a visual examination of the lesions. If there is bleeding or diagnostic uncertainty, a small tissue sample, known as a biopsy, may be examined. The condition can be mistaken for other issues like genital warts, herpes, or skin tags, so a professional diagnosis is important for confirmation.
Treatment
Active intervention is not typically required as the condition is harmless. However, lesions can be removed for cosmetic reasons or to address patient concerns about confidence and intimacy. Treatment is also necessitated if the papules cause troublesome intermittent bleeding.
Prevention
There is no specific advice for preventing Angiokeratoma of Fordyce. The loss of supporting tissue elasticity around capillary walls can be genetic, making risk reduction for recurrence difficult.
Prognosis
The long-term prognosis is excellent as the condition is benign and does not become cancerous. The angiokeratomas do not disappear on their own and may increase in number over time. Following treatment, lesions may recur years later in the same or different genital areas.
FAQs
Angiokeratoma of Fordyce appears as spots in the genital area, ranging anywhere from dark red to purple, or almost black in colour. Most commonly they appear on the scrotum, but they can also appear on the vulva or on or around the penile skin. Most patients tend to have lesions between 1-5mm in size but much larger lesions can be seen in more advanced cases where lesions may be large enough to look like warts. The angiokeratomas may show up individually or in clusters and the papules often have tiny visible capillaries connecting the larger blood filled lesions.
Most patients do not feel any discomfort from the angiokeratomas, however, some patients may feel a bit of discomfort accompanied by a sense of warmth and itching. They tend to bleed if traumatised or accidentally cut during shaving or trimming.
Some patients can have angiokeratomas, skin tags and genital warts all at the same time. If you are unsure what lesions you have, seek medical advice for the correct diagnosis.
If the Angiokeratoma of Fordyce is the result of an underlying condition, such as Fabry disease, other symptoms may be present. These symptoms include pain in the upper and lower limb extremities, tinnitus (a ringing sound in the ear), lack of sweat (hyphohidrosis), cloudy vision, or lower abdominal pain.
Angiokeratoma of Fordyce can occur anywhere on the genitalia but commonly occur on the scrotum and the vulva. They are seen less commonly on the glans penis and penile shaft. Other types of angiokeratomas can occur elsewhere on the body, but Angiokeratoma of Fordyce is only present in the genital area.
Anyone can develop Angiokeratoma of Fordyce. Most people with these lesions have no underlying medical problems. It most commonly affects patients that are 50 years old or above, and it is more common in male patients.
Angiokeratoma of Fordyce does not go away on its own. They can, however, grow in number overtime.
In most cases, Angiokeratoma of Fordyce present on the skin does not progress to anything serious. It is not sexually transmitted or contagious, and does not cause cancer.
Troublesome intermittent bleeding from the lesions can be an issue for some patients, necessitating the treatment of these lesions.
You can get other types of angiokeratomas in different areas of your body, but Angiokeratoma of Fordyce only occurs in the genital area.
Angiokeratoma of Fordyce can occur when blood vessels near the skin’s surface break or dilate, causing a bump on the skin. A common cause for this is when the supporting tissue around the capillary walls loses its elasticity.
No, Angiokeratoma of Fordyce is not an STI, and it can not be transmitted to someone else through sexual contact. Angiokeratoma of Fordyce is also not cancerous.
Typically, a diagnosis can be made by a visual examination. However, in the event of bleeding or other concerns, the doctor might take a small tissue sample called a biopsy to examine under the microscope.
Angiokeratoma of Fordyce may be easily mistaken as other conditions, such as:
- Genital warts
- Genital herpes
- Molluscum contagiosum
- Skin tags
- Skin inflammation (folliculitis)
- Other benign skin conditions such as milia (hard bumps on the skin due to the build-up of keratin)
- Basal cell carcinoma
If you are unsure whether you have Angiokeratoma of Fordyce, particularly if the lesions are newly visible, it is important to see a healthcare professional for an accurate diagnosis.
Unless there is diagnostic uncertainty, confirmation beyond an examination by your clinician is not normally required.
Of course. We understand that you may wish for a second pair of eyes to assess your condition. You are more than welcome to book an appointment with another clinician as well - either at our clinic or elsewhere.
There is no need to worry as it is a benign condition and does not lead to cancer.
Lesions may recur years later in the same or different areas.
A common cause for Angiokeratoma of Fordyce is that the supporting tissue around the capillary walls loses its elasticity. Because this can be genetic there is no specific advice for how to reduce the risk of recurrence.
As Angiokeratoma of Fordyce is not infectious or sexually transmitted there is no implication or concerns for your sexual partner(s). There is no requirement for you to share your diagnosis with your partner(s). Your partner(s) will also not require any treatment.
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Page last reviewed by Ms. Magdalena Nowacka on 13 June 2023 for general guidance only. It is not intended to replace the advice of your clinician.