Tufted angioma or angioblastoma of Nakagawa is a rare vascular tumor that usually appears in early childhood. It frequently is seen as an erythematous to red-brown, frequently indurated plaque that usually occurs on the trunk or neck. Typically tufted angiomas enlarge for a few years and then cease growing and remain stable. Histopathologic findings are pathognomonic. We describe a patient with a tufted angioma of the thigh who sought treatment for paroxysmal episodes of pain. Treatment with topical clobetasol propionate resulted in a decreased frequency of painful episodes.