Figure 1.

Clinical presentation of erythematotelangiectatic macules distributed over extensor surfaces of the arms and forearms in 50-year-old male (A, B).

Contact polarized dermatoscopic image (DL5, Dermlite, US) of the lesion displays a vascular pattern of thick linear serpentine vessels with alternating regions of constrictions and dilations (a sausage-string appearance) of reticular/polygonal arrangement (better seen in the box) (C).

Ultraviolet-induced fluorescence dermatoscopy (365nm) (DL5, Dermlite, US) demonstrates vascular constrictions and dilations (a sausage-string appearance) of reticular/polygonal arrangement along with darkening of perivascular structureless areas (higher absorption of UV spectrum by hemoglobin) suggestive of underlying endothelial dysfunction and erythrocyte extravasation (better seen in the box) (D).

Sub-ultraviolet reflectance dermatoscopy (405nm)(DZ-D100, Casio, Japan) exhibits hyporeflective linear serpentine reticular/polygonal vessels with indistinct contours (higher absorption of UV spectrum by hemoglobin) suggestive of underlying endothelial dysfunction and erythrocyte extravasation (better seen in the box) (E).

Pathology displays thinned epidermis with reduced papillomatosis, numerous dilated vessels of the superficial vascular plexus (no perivascular infiltrate noted), and fragmented elastin fibers in the upper dermis that could support the diagnosis of both generalized essential telangiectasia and cutaneous collagenous vasculopathy (F), but thickened hyalinized walls of the vessels support the diagnosis of the CCV (G).