Tufted angiomas

Published on 11/06/2015 by admin

Filed under Pediatrics

Last modified 22/04/2025

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Plaque-type tufted angioma on the neck of a 4-year-old girl.

Satellite lesions of tufted angioma on the neck of the same girl as the previous image.

Solitary tufted angioma on the leg.

Nodular-type tufted angioma on the thigh of a 2-week-old boy.

CLINICAL FEATURES

Tufted angiomas are described histologically by discrete, dermal, cannonball-like tufts of endothelial cells.

The classic type is that of a slowly expanding, dusky, reddish-blue vascular plaque. More than 50% occur on the head, neck, upper arms and upper back. Satellite lesions may be seen. The majority of lesions arise within the first two decades of life. Regression in this type of tufted angioma is not expected.

The other type is a solitary vascular nodule presenting on an extremity at birth. This type of tufted angioma does not exhibit the slow expansion seen in the other clinical type and satellite lesions are not seen. Regression of this type of tufted angioma has been reported, although it may have been confused with a RICH (rapidly involuting congenital hemangioma).

Nodular type tufted angiomas may be confused clinically with nodular venous malformations, RICH and NICH (non-involuting congenital hemangioma).

Kasabach−Merritt syndrome may be seen in association with tufted angiomas and it has been argued that tufted angiomas may be in the spectrum of hemangioendotheliomas.

TREATMENT

Vascular-specific pulsed dye lasers have been used with variable success for the plaque-like type.

Nodular types may be removed by surgical excision.

If Kasabach−Merritt syndrome occurs this should be treated appropriately. Optimal first-line treatment is controversial and based on case reports. Oral steroids, vincristine, interferon-alpha, surgical excision, radiotherapy and most recently propranolol have been used.

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