The Spectrum of Cutaneous Reactive Angiomatoses in End Stage Renal Failure

Cutaneous reactive angiomatoses encompass a spectrum of conditions driven by underlying occlusive vasculopathy. We present 2 cases of reactive angioproliferation in the context of end-stage renal failure (ESRF) manifesting as painful cutaneous ulceration. The first case demonstrates histologic features of diffuse dermal angiomatosis. The second case illustrates a nonspecific pattern of vascular proliferation which does not conform to any of the classically described subtypes, therefore reinforcing the concept of a spectrum of histopathologic changes in reactive angioproliferations. Diffuse dermal angiomatosis has been described in ESRF alone and in association with calciphylaxis, a life-threatening condition. Recognizing the patterns of reactive angioproliferation in the context of ESRF therefore has clinical relevance. Earlier identification may facilitate mitigation of risk factors and improve prognosis.