A Case of Angiolymphoid Hyperplasia with Eosinophilia Treated with Combination Therapy of Topical and Intralesional Corticosteroids

Main Article Content

Olga Marushchak
Nehal Shah
Mark Jacobson
Adriana Ros

Keywords

angiolymphoid hyperplasia with eosinophilia, topical clobetasol solution, intralesional triamcinolone

Abstract

Angiolymphoid hyperplasia with eosinophilia is an uncommon, benign vasoproliferative disorder that can present with single or multiple pink to red-brown dome shaped papules, predominantly on the head and neck. The most common reported symptoms include, but are not limited to, pruritus, bleeding and pain. Currently, there is no definitive treatment for this condition, with numerous therapeutic modalities described in the literature. The most effective and commonly used treatment is excision but can be more invasive and still has a high failure rate (40.3%). Despite the high failure rates associated with topical, systemic and Intralesional corticosteroids, we were able to show significant improvement with the combination of topical and Intralesional corticosteroids. This form of therapy is considerably cheaper and non-invasive compared to alternative therapies. Given the high recurrence and lack of definitive treatments, more research is needed for a better understanding of pathophysiology and identification of effective therapies. 

References

1. Adler BL, Krausz AE, Minuti A, Silverberg JI, Lev-Tov H. Epidemiology and treatment of angiolymphoid hyperplasia with eosinophilia (ALHE): A systematic review. J Am Acad Dermatol. 2016;74(3):506-12.e11. doi:10.1016/j.jaad.2015.10.011

2. Alaidarous A, Bouissou X, Mazereeuw-Hautier J, Bulai-Livideanu C, Lamant L, Paul C. Angiolymphoid hyperplasia with eosinophilia treated with low-dose methotrexate. JAAD Case Rep. 2015;1(6):342-344. Published 2015 Sep 27. doi:10.1016/j.jdcr.2015.08.006

3. Lembo S, Balato A, Cirillo T, Balato N. A Long-Term Follow-Up of Angiolymphoid Hyperplasia with Eosinophilia Treated by Corticosteroids: When a Traditional Therapy is Still Up-to-Date. Case Rep Dermatol. 2011;3(1):64-67. Published 2011 Mar 5. doi:10.1159/000323182

4. Azari AA, Kanavi MR, Lucarelli M, et al. Angiolymphoid hyperplasia with eosinophilia of the orbit and ocular adnexa: report of 5 cases. JAMA Ophthalmol. 2014;132(5):633-636. doi:10.1001/jamaophthalmol.2013.8243

5. Aggarwal A, Keluskar V. Epithelioid hemangioma (angiolymphoid hyperplasia with eosinophilia) in the oral mucosa. Indian J Dent Res. 2012;23(2):271-274. doi:10.4103/0970-9290.100439

6. Bui MM, Draper NL, Dessureault S, et al. Colonic angiolymphoid hyperplasia with eosinophilia masquerading as malignancy: a case report and review of the literature. Clin Colorectal Cancer. 2010;9(3):179-182. doi:10.3816/CCC.2010.n.025

7. Khanna G, Sharma S, Rajni. Angiolymphoid hyperplasia with eosinophilia involving bone. Indian J Pathol Microbiol. 2007;50(4):844-846.

8. Chitrapu P, Patel M, Readinger A, Menter A. Angiolymphoid hyperplasia with eosinophilia. Proc (Bayl Univ Med Cent). 2014;27(4):336-337. doi:10.1080/08998280.2014.11929150

9. Stewart N, Zagarella S, Mann S. Angiolyphoid hyperplasia with eosinophilia occurring after venipuncture trauma. J Dermatol. 2013;40(5):393-395. doi:10.1111/1346-8138.12106

10. Zarrin-Khameh N, Spoden JE, Tran RM. Angiolymphoid hyperplasia with eosinophilia associated with pregnancy: a case report and review of the literature. Arch Pathol Lab Med. 2005;129(9):1168-1171. doi:10.5858/2005-129-1168-AHWEAW