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Correspondence |

Angiolymphoid Hyperplasia With Eosinophilia Revisited: Lack of Durable Response to Intralesional Interferon Alfa-2a

Caitlin M. Fink, DO; Kurt L. Maggio, MD
Arch Dermatol. 2011;147(4):507-508. doi:10.1001/archdermatol.2011.69.
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Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare vascular disorder of unknown pathogenesis that has a predilection for young white women. It usually presents as pink to red-brown, dome-shaped, dermal papules or nodules of the head and neck, most often in the periauricular area. Symptoms may include pain, pruritus, and spontaneous bleeding after minor trauma. Histologically, ALHE demonstrates a proliferation of thick-walled vessels with prominent endothelial cells (hobnailing) as well as an infiltration of lymphocytes and eosinophils.1 Multiple treatments have been reported, including intralesional injection with interferon alfa-2a, surgery, and various lasers including argon, carbon dioxide, and pulsed dye.2

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Figure 1.

Clinical images of our study patient. A, At presentation in June 1999, the patient demonstrates extensive right periauricular violaceous papules with edema and external auditory meatus stenosis. B, Four months after the patient's final laser treatment, normal ear contours are restored. C, Photograph taken October 1, 2010, demonstrating complete resolution of angiolymphoid hyperplasia with eosinophilia.

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Figure 2.

Hematoxylin-eosin–stained histopathologic images from our subject case. A, Dermal infiltrate seen on low-power magnification (original magnification ×40). B, Mixed infiltrate consisting of lymphocytes and eosinophils (original magnification ×100). C, Vessel demonstrating prominent endothelial cells entering into the lumen (original magnification ×100).

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