Verrucous venous malformation and lymphatic malformation, former similar phenotypes where cell-free DNA could clarify in genotype

To the Editor: We thank Gu et al1 for their great suggestions on our comments regarding García-Montero et al’s2 case series reporting the use of topical rapamycin for superficial lymphatic malformations (LMs). Verrucous venous malformation (VVM), formerly known as verrucous hemangioma, is an uncommon vascular anomaly that primarily involves the skin and subcutaneous tissue and is characterized by a variable degree of skin hyperkeratosis.3 Our comments on the differential diagnosis of microcystic LM and VVM were written and first published in 2019.