Clinical and Histopathologic Study on Tufted Angioma / 대한피부과학회지

ABSTRACT

BACKGROUND: Tufted angioma, a rare vascular disorder found typically in children, usually involves in the trunk and neck with characteristic "cannonball" distributed vascular tuft. OBJECTIVES: The purpose of this study was aimed to characterize the clinical and histopathologic features of tufted angioma. METHODS: Clinical examinations were performed on 7 patients with tufted angioma regarding the age, sex, duration, sites, clinical morphology, associated symptoms and treatments and disease course. Histopathologic studies of 8 specimens obtained from 7 patients were performed with routine hematoxylin and eosin staining and immunohistochemical staining with anti-factor VIII- related antigen antibody. RESULTS: 1. Male-female ratio was 10.75 (male patients were 4 and female patients were 3). Onset of the skin lesions ranged from birth to 67 years of age. Over 40 years of age were 4, 2 patients had the skin lesion at birth and 1 patient found the lesion at 67 years of age on the preexisting nevus flammeus. 2. Typical clinical features showing patch with papules were seen in 4 patients, patch only was seen in three patients. 3. 4 patients had the lesion on the proximal extremities, 2 on the trunk, 1 on the finger and one. Mild tenderness was noted in 3 patients, mild hyperhidrosis in 1 and severe tenderness and pain in 1 patient. 4. Histopathologic studies revealed typical vascular tufts with "cannonball" distribution in the dermis. Immunohistochemical staining performed on 2 cases showed weak positivity to factor VIII-related antigen. 5. In 1 patient, because of small size of the skin lesion, a simple excision was possible. Another 2 patients were being treated with dye laser with minimal improvement, 1 patient showed spontaneous complete regression. However in the 2 patients without treatment, the skin lesion was persisted in 1 patient and the other died of underlying malignancy. CONCLUSION: Though there was no statistical significance for the short number of patients, tufted angioma occurred not only in early childhood but also in adulthood with the predilection sites of the proximal extremities and the trunk. Clinical manifestations were erythematous papulo-patch or patch. Histopathologically, typical proliferation of the blood vessel with the array of cannonball was observed. As reported, several treatments have been tried, and there was a case of self-remission.