Argon laser therapy of vulvar angiokeratoma

A 25-year-old woman with Noonan syndrome presented with painful, bleeding lesions of the vulva and perineum. The histologic diagnosis was angiokeratoma. Chronic increased central venous pressure from the patient's underlying cardiac disease was felt to be etiologic. The Argon laser was used for ablation, with minimal blood loss despite the extreme vascularity of these lesions.