Cutaneous arterial fibromuscular dysplasia: a case report and electron-microscopic study

A case of a 39-year-old female with fibromuscular dysplasia (FMD) manifesting subcutaneous pulsatile nodules on the right side of her forehead and on her right wrist is reported here. These nodules proved to be FMD aneurysms of the frontal ramus of the right superficial temporal artery and the right radial artery. The patient had also suffered a stroke with subarachnoidal bleeding as a result of this disease. Angiographic examination showed aneurysms in the union and the bilateral vertebral arteries, a branch of the right renal artery, and one the right lumbar artery. A biopsy specimen taken from the frontal branch of the right superficial artery revealed segmental intimal thickening consistent with intimal fibroplasia type FMD upon histological examination. Electron-microscopic findings were also discussed in connection with the histogenesis of the disease. This appears to be the second case of FMD involving arteries in the skin to be reported in the dermatological literature.