Clinical, dermoscopic and histopathological features of spontaneous scalp or face and radiotherapy-induced angiosarcoma

Cutaneous angiosarcoma is a rare, aggressive malignant vascular neoplasm with a poor prognosis.1, 2 Four main variants are currently recognised, namely; sporadic angiosarcoma (AS) of the scalp and face, lymphedema associated angiosarcoma (LAS), radiation‐induced angiosarcoma (RIA) and the recently described rare, aggressive epithelioid subtype.3, 4 Among these four variants, angiosarcoma of the scalp and face, also known as Wilson–Jones angiosarcoma, senile angiosarcoma or malignant angioendothelioma is the most common. The disease mainly affects elderly individuals with a male predominance. LAS develops in the context of chronic lymphoedema after a mastectomy or other oncological or surgical interventions, whereas RIA occurs often years after radiotherapy in the radiation field.5 In oncology patients with post‐surgery induced chronic lymphoedema who have received additional radiation therapy, the exact differentiation between LAS and RIA is not clear.