Tufted angioma in ear auricle: importance of the differential\ndiagnosis
A 12-year-old male patient, a student from Ananindeua, Pará, looked for medical care,\naccompanied by his father, due to right ear auricle volume increase that had started 5\nyears ago. He reported that the increase in volume began associated with a "red" (sic)\nspot, which progressively expanded causing a large volume increase of the large helix of\nthe right ear, with light local itching, without other symptoms. He denied previous\ntreatments, local traumatism or comorbidities.\nConsidering the epidemiology of the region and the infiltrative aspect of the external\near size increase, as well as a weakly-positive anti-PGL1 test done previously, the\npatient was referred from another service with a diagnosis of Lepromatous Leprosy, to\nstart polychemotherapy. However, the rate of evolution, the clinical condition and the\nclinical lesion were not consistent with this diagnosis, so a biopsy of the lesion was\ndone for better clarification.\nThe dermatological exam showed volume increase of the large helix of the right ear,\nwell-defined erythematous macules with irregular contours, the largest one measuring 07\nx 06 cm; two erythematous papules on the anterior portion of the helix, besides\nincreased local temperature on the right ear large helix and retroauricular region\n( and ).\nThe histopathological exam showed dermis with proliferation of vascular nature,\norganized in lobes, composed of capillaries, venules and harder endothelial ovoid cell\naggregates. The stroma presented a desmoplastic aspect, with scarce focal lymphocytic\ninflammatory infiltrate. The diagnosis was Hemangioma, variant tufted hemangioma ( and ).\nSince it was a benign lesion, expectant management was adopted and no other vascular\nmalformation was evident after imaging exams.