Tufted angioma

Twenty patients (11 female, nine male) are described, with unusual, slowly progressive angiomas which usually arose on the neck and upper trunk in young patients. Histologically these angiomas were characterized by small circumscribed angiomatous tufts and lobules scattered in the dermis, hence the suggested title of ‘tufted angioma’. Half the angiomas arose in the first 5 years of life with only three of the lesions present at birth. However, in three patients the onset was after the age of 40. The lesions were predominantly macular, but some showed superficial papules or a deep‐seated nodular component. Some of the lesions were tender on palpation. Most lesions slowly extended so that eventually a large part of the trunk and neck was affected in some patients. Despite progression, the course was benign and malignant change has not been reported. Histologically, tufted angiomas show some similarity to the cellular angiomas of strawberry naevi, but the angiomatous lobules are much larger and more deeply situated in the latter. A panel of cell marker studies (Factor VIII‐related antigen, the lectin UEA‐I, and monoclonal antibodies EN 4 and PAL‐E) indicated the main constituent cells to be endothelial cells. Familiarity with this acquired angiomatous condition in young persons should prevent confusion with AIDS‐related Kaposi's sarcoma and other malignant vascular tumours.