Interferon for tufted angioma

Acquired tufted angioma of upper lip: case report and review of the literature

Acquired tufted angioma is a rare, cutaneous and slow growing benign vascular neoplasm that usually affects pediatric populations. Only six cases of oral mucosal acquired tufted angioma have been reported in the English language literature. We present in this report the seventh case and discuss its clinical and pathological features.

Kaposiform hemangioendothelioma

Kaposiform hemangioendothelioma (KHE) is a rare, locally aggressive vascular neoplasm that mainly occurs during childhood. It generally originates on the skin, usually affecting deeper tissue by infiltrative growth. It appears as one or multiple masses, and in most cases is associated to consumptive coagulopathy (Kasabach-Merritt syndrome), and lymphangiomatosis. Although visceral involvement is very uncommon, several cases with bone, retroperitoneal, or mediastinal involvement have been described. These tumors tend to be locally invasive, but are not known to produce distant metastases. The development of KHE in adolescents or in adults is very rare, but cases have also been described. Several factors are associated with the outcome of patients with KHE: accessibility to surgical excision, location (cutaneous versus visceral), size of tumoral mass, clinical response to interferon and glucocorticoids, and the absence of lymphangiomatosis and Kasabach-Merritt syndrome, may result in partial remissions. On the other hand, bulk visceral masses lead to a 40-50% mortality rate, mainly due to progressive failure of the infiltrated organ(s), in spite of interferon, glucocorticoids, and combined chemotherapy. In conclusion, the onset of a consumptive coagulopathy following the presence of a vascular tumor, in children as well as in older patients, should spark suspicion of KHE, among other entities.

Off-label uses of biologics in dermatology: Interferon and intravenous immunoglobulin (Part 1 of 2)

The introduction of a number of biologic therapies into the market has revolutionized the practice of dermatology. These therapies include interferons, intravenous immunoglobulin, infliximab, adalimumab, etanercept, efalizumab, alefacept, and rituximab. Most dermatologists are familiar with the Food and Drug Administration-approved indications of these medications. However, numerous off-label uses have evolved. As part 1 of a 2-part series, this article will review the literature regarding the off-label uses of the interferons and intravenous immunoglobulin in dermatology.

Tumeur vasculaire géante de l’adulte : angiome en touffe ou hémangioendothéliome kaposiforme

INTRODUCTION

Tufted angioma and kaposiform hemangioendothelioma are two rare benign but aggressive vascular tumours that occur mainly in children.

OBSERVATION

A 72 year-old man consulted for a 50 cm wide vascular tumour of the right shoulder which was increasing for 10 years. On histological examination there were features of tufted angioma and kaposiform hemangioendothelioma.

DISCUSSION

The tumour of this patient was atypical because of its big size never described before. The histological association of aspects which could correspond to tufted angioma and kaposiform hemangioendothelioma seems to confirm recent publications which support the hypothesis that these two tumours are two evolutive stages of one and only entity.

Tufted angioma: a report of five cases

Tufted angioma is a rare, benign, vascular tumor, characterized histologically by tufts of capillary-sized vessels in the dermis. Five patients were diagnosed over a 10-year period. All developed the lesions within the first year of life. Four were Chinese and one was Indian. There was no sex predilection. All the lesions occurred on the limbs, mainly proximally, with 40% affecting the upper and 60% the lower limbs. The appearance ranged from erythematous, indurated, annular nodules to plaques. In two patients the lesions had overlying red papules, and hypertrichosis was present in three cases. The lesions were tender in all patients. No complications such as ulceration, bleeding, or Kasabach-Merritt syndrome occurred. All were treated conservatively, with improvement in tenderness in three of four patients after a period of 5 months to 4 years. Decrease in size occurred in one of four patients after 2 years. Our series differs from previous ones in that all the patients developed the lesions before the age of 1 year, all lesions occurred on the limbs, and all were tender. Tenderness and hypertrichosis, in addition to induration, may be useful in the clinical differentiation from common hemangioma.