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Tufted Angioma
Tufted angioma

Images

WIKIDATA, CC BY-SA 3.0

Presentation

Lesions typically present during infancy or early childhood and are most commonly reported to persist and/or expand over time. Congenital presentations are rare, as are reports of spontaneous regression. [ncbi.nlm.nih.gov]

Entire Body System

  • Pain

    It is characterized by painful purplish macules that may progress to plaques containing angiomatous papules. [ncbi.nlm.nih.gov]

    However, it can be stated that the improvement in pain justified its use. In this case, there were no side effects, only pain during application of the method, which reinforces its safety. REFERENCES 1. [scielo.br]

  • Asymptomatic

    […] sized erythematous patch (Ann Dermatol 2013;25:129) 2 month old girl with widespread disseminated red papules (J Cutan Pathol 2013;40:405) 47 year old woman with red, infiltrated, solitary plaque (An Bras Dermatol 2015;90:16) 72 year old man with 2 asymptomatic [pathologyoutlines.com]

    Port-wine stain that progresses to an angiomatous tumor, varying in size from 2 to 10cm, most often found on the upper trunk, cervical area, and proximal aspect of the limbs, besides other locations such as face and oral mucosa. 1 Lesions are usually asymptomatic [scienceopen.com]

    They were completely asymptomatic and she had come purely for the cos-metic disfigurement. Examination revealed 50 to 60 soft papules and nodules varying in size from 0.2 cms x 0.2 cms to about 4x3 cms. Button hole sign was seen in the nodules. [ijdvl.com]

    However, familial cases have also been reported. [6] The lesions are usually asymptomatic but, rarely, paroxysmal painful episodes may occur. Tenderness is a usual feature, which was absent in our case. [e-ijd.org]

    Solitary cutaneous TA is an asymptomatic lesion with excellent prognosis as reported in our report. [acr.amegroups.com]

  • Inflammation

    […] vessels with small oval to spindle shaped cells throughout the dermis and subcutaneous tissue imparting a “cannonball” or glomerular appearance May have variable mitoses without nuclear atypia Hemosiderin may be present; in contrast to pyogenic granuloma, inflammation [pathologyoutlines.com]

    This is a reactive lesion that develops rapidly, bleeds easily and is usually associated with inflammation and ulceration. [cda-adc.ca]

    Inflammation and oedema are not seen. There may be some hemosiderin pigment deposition. There is no cytological atypia. Some mitotic figures may be present.. [histopathology-india.net]

    Oedema and inflammation is absent. [jcdr.net]

  • Pallor

    NICH are usually flatter than RICH and present as a well-circumscribed, round to oval, slightly indurated or raised, soft-tissue mass with a blue-purple collar or with coarse superficial telangiectasia and rim of pallor. [dermatologyadvisor.com]

  • Episodic Pain

    In the subsequent years, she experienced episodic pain at the same site, but no specific therapy was given. [nature.com]

Skin

  • Papule

    A 4-month-old girl developed coalescing, red-purple, firm plaques with irregular borders and superimposed papules in the left groin. The lesions were tender to palpation and they slowly expanded and became thicker over the next year. [ncbi.nlm.nih.gov]

  • Hypertrichosis

    Tenderness and hypertrichosis, in addition to induration, may be useful in the clinical differentiation from common hemangioma. [ncbi.nlm.nih.gov]

    […] vaccination sites Sites Commonly found on neck, shoulders and trunk Cranial and facial lesions are uncommon Clinical features Erythematous, poorly defined mottled macules and plaques typically ranging from 2 - 5 cm Usually solitary May have overlying hypertrichosis [pathologyoutlines.com]

    […] varying in size from 2 to 10cm, most often found on the upper trunk, cervical area, and proximal aspect of the limbs, besides other locations such as face and oral mucosa. 1 Lesions are usually asymptomatic, but can be very painful and present with hypertrichosis [scienceopen.com]

    Hypertrichosis can also be seen in association with tufted angioma [6,7]. The lesions may persist for years and can regress spontaneously. Localised hyperhidrosis was present in some of the case [8]. [omicsonline.org]

  • Lanugo

    There was no evidence of sweating or excessive growth of lanugo hair over the plaque. Thrill and bruit were absent over the plaque. [bioline.org.br]

    They may also be covered by lanugo hair. Proliferation of eccrine glands can lead to hyperhidrosis. [contemporarypediatrics.com]

    […] the tumor during childhood. [19, 20] Most reported tumors occur on the trunk, arms, and legs, while tumors of the face and scalp are rare. [18] Involvement of the feet and oral mucosa is observed, but only in rare cases. [21, 22] Hypertrichosis with lanugo [emedicine.medscape.com]

    (Courtesy of Ilona Frieden, MD) Related Content Focal hyperhidrosis or hypertrichosis overlying the lesions can be an important clinical clue to diagnosing TA, with a lanugo-like appearance to the hairs (Figure 4). [dermatologyadvisor.com]

  • Subcutaneous Nodule

    Images hosted on other servers: Subcutaneous nodule Microscopic (histologic) description Multiple, scattered lobules of small capillary type vessels with small oval to spindle shaped cells throughout the dermis and subcutaneous tissue imparting a “cannonball [pathologyoutlines.com]

    Characteristic findings on physical examination Spindle cell hemangiomas (SCH) present as slowly growing, vascular-appearing, solitary or multiple, dermal or subcutaneous nodules with a preference for the distal extremities. [cancertherapyadvisor.com]

  • Macula

    This lesion was seen at the age of 7 as a small, asymptomatic red wine macula, which grew progressively. At present it is slightly painful and presents papular areas. [elsevier.es]

Workup

Laboratory tests that may be important in the workup of TA include a basic screen of coagulation factors; particularly complete blood count with platelets, D-dimers, and fibrinogen, but also prothrombin time (PT), partial thromboplastin time and international [dermatologyadvisor.com]

Microbiology

  • Human Herpesvirus 8

    It also usually stains positively for human herpesvirus 8 (HHV-8), whereas TA does not. IHs usually have a distinct architecture, with lobules of endothelial channels separated by fibrous bands. [dermatologyadvisor.com]

Treatment

Effective treatments reported in the literature are scarce. We report a case of tufted angioma in a child, which had a successful outcome after treatment with the pulsed-dye laser both in terms of cosmesis and alleviation of pain and discomfort. [ncbi.nlm.nih.gov]

Treatment Our team at the Birthmarks and Vascular Anomalies Center has a great deal of experience in the treatment of TA. The type of treatment will depend on whether or not Kasabach-Merritt phenomenon is present. [ucsfbenioffchildrens.org]

Prognosis

It has been associated with Kasabach-Merritt syndrome, a severe coagulopathy of poor prognosis. There have been very few published cases of oral tufted angiomas, and maxillary bone involvement has not been hitherto reported. [ncbi.nlm.nih.gov]

In such cases, a surgical removal of the lesion is the preferred method of treatment The prognosis of Tufted Angioma is typically good with suitable therapy. [dovemed.com]

The authors describe in-depth the clinical and morphologic aspects of each entity and detail their clinicopathologic correlation, differential diagnosis, prognosis, and therapy. [books.google.com]

Etiology

Its etiology and pathogenesis are uncertain. Tufted angioma typically occurs during infancy or early childhood and displays various clinical patterns. [ncbi.nlm.nih.gov]

TERMINOLOGY Synonyms Acquired tufted angioma (ATA) Angioblastoma (of Nakagawa) Progressive capillary hemangioma Tufted hemangioma Definitions Multiple cannonball-like, scattered cellular collections of small vessels in dermis ETIOLOGY/PATHOGENESIS Unknown [basicmedicalkey.com]

Etiology Kasabach-Merritt syndrome is usually caused by kaposiform hemangioendothelioma or tufted angioma. Other vascular tumors may be responsible, such as infantile hemangioma. The radiographic features are specific to each vascular tumor. [radiopaedia.org]

The etiology of kaposiform hemangioendothelioma remains unknown. It is not associated with HHV8 infection or Kaposi sarcoma. Tumors often involve soft tissue of extremities as ill-defined, violaceous lesions and may encase normal structures. [path.upmc.edu]

Epidemiology

Her main area of interest is cancer epidemiology, with a particular focus on melanoma and other skin cancers. Nagwa M. Elwan is Professor of Dermatology at the Faculty of Medicine, Tanta University, Egypt. [books.google.com]

Note the characteristic podoplanin / D2-40 stain https://twitter.com/ikletskaya/status/822082053814493184 Epidemiology sporadic or familial (autosomal dominant with reduced penetrance) usually occurs in children younger than 5 years may occur in adults [humpath.com]

[…] lobular pattern Considered to be on the same neoplastic spectrum as kaposiform hemangioendothelioma; some consider it to be the same entity Terminology Synonyms: Tufted angioma, Nakagawa’s angioblastoma, progressive capillary hemangioma, tufted hemangioma Epidemiology [pathologyoutlines.com]

Summary Epidemiology The prevalence is unknown but around 200 cases have been described in the literature. [orpha.net]

Pathophysiology

Tufted angiomas usually have a benign course, with only rare reports of aggressive behavior or local invasion. [1] However, tufted angiomas seldom self-involute. [2] Pathophysiology The pathogenesis of tufted angiomas is not well understood. [emedicine.medscape.com]

Pathophysiology The reasons for and mechanism of vascular proliferation are unclear. Some have postulated that high estrogen levels may promote proliferation of TA (because of cases arising in pregnancy). [dermatologyadvisor.com]

Prevention

Familiarity with distinctive histologic features of tufted angioma should prevent these lesions from being misdiagnosed as either Kaposi's sarcoma or as angiosarcoma. [ncbi.nlm.nih.gov]

Some tumors, in rare cases, are also known to regress by their own Please find comprehensive information on Tufted Angioma regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention, prognosis [dovemed.com]

It can also be used in conjunction with excision to prevent recurrence and shrink remaining tumor burden. Typical dosing is 0.25mg/kg/weekly for many weeks, depending on response. [dermatologyadvisor.com]

Consequently, we chose radical excision of the lesion to prevent, if the medical treatment was ineffective, the lesion from reaching critical areas. Various options exist for medical treatment. [elsevier.es]

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