We report two cases of tufted angioma with atypical clinical presentations in adults.Patient 1 was a 41-year-old male with painful red plaques on his neck for 2 years.Cutaneous ex-amination showed dark red papules distributed in clusters on the red plaques(7 cm × 3.5 cm in size)of the neck,tough texture and some pseudo-vesicular lesions.Laboratory tests revealed a platelet(PLT)count of 83 × 109/L and abnormal coagulation.Histopathology revealed nodular endothelial cell hyperplasia arranged in tufts and looked like"cannonball"appearance in the der-mis and subcutaneous tissue.Immunohistochemical stainings of CD31 and CD34 were positive,and D2-40 was focally positive.Diagnosis:Tufted angioma.The patient refused the treatment with oral propranolol,but was still under follow-up.Patient 2 was a 30-year-old female with a brown nodule on the left dorsal foot,accompanied by pruritus and pain for over two months.Dermatologi-cal examination showed a brown nodule in a diameter of about 0.8 cm,with a hard and rough sur-face.Laboratory tests were normal in routine blood test,liver,kidney and coagulation functions,except elevations in IgG(23.70 g/L)and C3(0.888 g/L),and ANA 1∶640(+).Histopatho-logical analysis revealed compact arrangement of endothelial cells with tuft proliferation in the der-mis.Immunohistochemical stainings of CD31 and CD34 were positive,and D2-40 was focally pos-itive.Diagnosis was tufted angioma.Surgical resection was given.
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