Angioqueratoma distal seudolinfomatoso infantil

Acral pseudolymphomatous angiokeratoma of children (APACHE) is a variant of cutaneous pseudolymphomas. In 1988, Ramsay, et al., reported five pediatric presenting with unilateral, multiple, persistent angiomatous papules on acral regions of the hands and feet. The histopathology of the lesions revealed a dermal lymphohistiocytic infiltrate well circumscribed with prominent thickened capillaries.Since the condition presents not only in childhood but also in adulthood and it is not characterized histopatohologically by the presence of angiomatous features, it is compelling to change the designation to “small papular pseudolymphoma” or “papular angiolymphoid hyperplasia”.  We present a one pediatric patient with an acral lesion (second toe of the left foot), whose diagnosis was reached through histopathology. We also make comments about this rare entity.