TUFTED ANGIOMA

CONGENITAL HEMANGIOMA

(RICH OR NICH)

INFANTILE HEMANGIOMA

PRESENT AT BIRTH

YES

YES

Precursor lesion in 1/3 of cases

CLINICAL MANIFESTATIONS

Purple-erythematous plaque or nodules on trunk, neck and limbs

Purple papules or nodules with depressed centres on head, neck and limbs

Bright red papules and plaques with finely lobulated surface

Warm blue-purple masses, possible presence of dilated veins or telangiectasias

NATURAL HISTORY

Postnatal growth

No postnatal growth

RICH: regression in  <1 year

NICH: persists throughout life

Short period of proliferation

Involution for years

HISTOLOGY

Capillary clusters forming lobules in dermis

Marked cellularity of  capillary lobules in dermis and SCT surrounded by fibrous tissue and  efferent vessels at the periphery

Endothelial cell hyperplasia, lobule formation, mast cells, prominent basement membrane

IMMUNOHISTOCHEMISTRY

GLUT-1 negative

GLUT-1 negative

GLUT-1 positive