Acral pseudolymphomatous angiokeratoma of children (APACHE) is a rarely reported, benign pseudolymphoma that presents predominantly in children and teenagers. The etiology is unknown, but it is classified as a pseudolymphoma due to its mixed B- and T-cell infiltrate.

APACHE is more common in females than males. Adult-onset cases have also been described. The clinical appearance of lesions varies. They most commonly appear as asymptomatic, unilateral, erythematous or violaceous angiomatous papules on an acral region, but they have been observed on the arm and leg. Papules are often clustered but may be solitary, linear, or coalescing into a plaque. There has been 1 reported case with accompanying nail plate dystrophy.

Without treatment, the lesions of APACHE will persist; however, treatment is not necessary given its benign nature.