Angiolymphoid Hyperplasia With Eosinophilia: Analysis of 7 Cases

Angiolymphoid hyperplasia with eosinophilia (ALHE), also known as epithelioid hemangioma, is a chronic, benign vascular proliferation for which no cases of malignant transformation have been reported to date. Spontaneous resolution has been described in some patients, particularly in those with small lesions. ALHE is characterized by a high rate of recurrence (approximately 30%), regardless of treatment modality. We describe the clinical and pathologic characteristics of 7 cases of ALHE diagnosed in our hospital between 2005 and 2011 (Table 1). Six of the patients were women; 5 of these were in their 40s and 1 was aged 75 years when the disease was diagnosed. The seventh patient was a 43year-old man. The predominant clinical presentation was erythematous papules and plaques (Fig. 1). Subcutaneous masses were observed in 2 cases. In all 7 patients, the lesions were located on the head and neck, specifically in retroauricular areas, on the helix of the ear, on the nose, on the temple, in the posterior cervical region, and in the frontal region (2 cases). The most common treatment was surgical excision (5 cases). This produced a satisfactory clinical outcome, although recurrence was observed in 4 cases. Recurrent lesions were treated with cryotherapy, intralesional corticosteroid injections, and electrocoagulation, resulting in complete resolution in 1 case; the remaining lesions remained stable. Spontaneous involution following biopsy was observed in 1 patient with a single papular lesion on the nasal dorsum. None of the patients had peripheral eosinophilia, palpable lymph nodes, or a history of trauma in the area of the