A healthy 79-year-old woman, Fitzpatrick phototype III, presented with asymptomatic lesions on the scalp and right ear evolving over a period of four months. Despite treatment with multiple antibiotics, no improvement occurred. Upon examination, an extensive erythematoviolaceous plaque with areas of alopecia was observed [Fig. 1A and B]. A punch biopsy confirmed the diagnosis of angiosarcoma characterized by epithelioid cells with a high proliferative index. Staging showed no distant metastasis, but the tumor was deemed unresectable. Pegylated liposomal doxorubicin was recommended, but the patient passed away before treatment. Skin angiosarcoma of the face is a rare vascular neoplasm known for its aggressive behavior and poor prognosis. Clinically, it can mimic cellulitis, hematoma, and other infectious or inflammatory conditions, leading to diagnostic delays. Timely recognition is crucial for prompt intervention
A- Clinical picture of a 79-year-old woman with an extensive erythematoviolaceous plaque affecting the entire scalp and right ear (front view). B- Clinical picture of a 79-year-old woman with an extensive erythematoviolaceous plaque affecting the entire scalp and right ear (lateral view).
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