Eruptive tufted angiomas in a patient with Crohn's disease

Surgical excision of a tufted angioma of the hand in an adult-a rare case report with a review of literature

Tufted Angiomas, also known as angioblastomas/Angioblastoma of Nagakawa, are rare vascular neoplasms of both sexes localised to the skin and subcutaneous tissues with the upper trunk and neck being the most common sites. They are more common in children but a few cases in juveniles and adults have been reported. Typically, Tufted Angioma remains stable or can show rarely a spontaneous regression. This article wants to evaluate the efficacy of current treatment modalities for tufted angioma (TA). A review was performed using PubMed database (Medline) for clinical studies. We report our case, a 29-year-old female who presented with a second finger of the left hand, painful, slowly progressive, firm swelling diagnosed as Tufted Angioma on histopathology and immunohistochemistry after complete surgical excision.

A tufted angioma

Tufted angioma (TA) is a rare, benign, cutaneous angiomatous proliferation. It is more common in children, usually presenting as red-purple painful plaques on the trunk. We describe here a TA observed at nine months of age, appearing initially over the retroauricular area, gradually extending to involve skin of neck and trunk by two years of age. This case of a large TA (7 × 12 cm) in an Indian male child is reported here due to its rare presentation.

Microvenular hemangioma presenting with numerous bilateral macules, patches, and plaques: a case report and review of the literature

Microvenular hemangioma (MVH) is a rare, slowly growing, benign vascular tumor that typically presents as a solitary enlarging plaque or nodule on the trunk or the extremities of young to middle-aged adults. A minority of MVH present with multiple lesions that are either gradually or suddenly acquired (eruptive MVH). Herein, we report a case of a 53-year-old woman who progressively developed numerous bilateral MVHs presenting as enlarging, blanching, erythematous to violaceous macules, patches, and plaques over the proximal thighs and axillae. Two biopsies exhibited the irregular branching venules with inconspicuous lumina lacking endothelial atypia and associated with dermal fibrosis characteristic of MVH. Immunophenotypically, the endothelium expressed Wilms Tumor 1, CD31, CD34, and erythrocyte-type glucose transporter protein (GLUT-1) GLUT-1 focally and was negative for Human herpes virus 8 and the lymphatic marker D2-40. In addition, numerous dermal spindle cells expressing CD34 and procollagen, putative fibrocytes, surrounded the thickened dermal collagen bundles and small vessels of MVH implicating a reactive/reparative (proliferative) process due to an unrecognized cutaneous injury. A review of MVH summarizing its clinicopathologic findings and its natural history is presented.

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.

Acquired multifocal tufted angiomas in an immunocompetent young adult

Tufted angioma (TA) is a rare benign vascular neoplasm, localized to the skin and subcutaneous tissues, occurring primarily on the trunk and extremities of children. The lesions are usually asymptomatic but, rarely, paroxysmal painful episodes may be associated. The occurrence of eruptive TA is still rarer and had been described almost exclusively in association with immunocompromised states. We report here a case of acquired painful multifocal tufted angiomas on the face and neck in an immunocompetent young adult.

Treatment with biologic therapies and the risk of cancer in patients with IBD

The proven involvement of cytokines in the pathophysiology of IBD has led to the development of powerful, selective, anticytokine drugs--so-called biologics--as a therapy for IBD. Although the efficacy of infliximab, a chimeric monoclonal IgG1 antibody directed against tumor necrosis factor, is proven and the use of biologic agents is growing worldwide, there is concern about their long-term safety, which includes the risk of developing cancer. An increased risk of malignancies, particularly lymphoma, has been reported in some studies of infliximab-treated patients with IBD; however, the increased risk could be caused by the underlying chronic disease, severity of the disease, concomitant medications (e.g. conventional immunomodulators), infliximab itself, or all of these variables. At present, the data do not provide clear evidence for a causal association between infliximab and the increased cancer risk. In appropriately selected patients with severe, refractory Crohn's disease, the benefits of biologic therapy seem to outweigh the cancer risk. Multicenter, case-control studies in large populations, with a long-term follow-up are needed to define the outcome of patients with IBD treated with biologic therapies.