Angiokeratomas from 116 patients were studied. Eighty-three percent of the patients had solitary lesions. Most solitary angiokeratomas are small, bluish to black, rough and warty growths occurring on all parts of the body but especially on the lower extremities. The diagnosis of angiokeratoma should be considered in the differential diagnosis of malignant melanoma. Fifteen percent, or 17, of the lesions were clinically diagnosed as melanoma and a wide surgical excision carried out. The lesion is classified as angiokeratoma but is considered distinctly different from the angiokeratomas of Mibelli, Fordyce, and Fabry by location and cause. It is considered a telangiectasia rather than a hemangioma.