Recurrent lobular capillary hemangiomas in a patient with neurofibromatosis type 1 (NF1) and von Hippel-Lindau syndrome (VHL)

L obular capillary hemangiomas, also known as pyogenic granulomas, are common, benign, vascular proliferations of the cutaneous or mucous surfaces that grow rapidly and are prone to ulceration and bleeding. Recurrence of lobular capillary hemangiomas in the same location after treatment is commonwith rates ranging from 3.7% to 43.5%. Well-known causes of lobular capillary hemangiomas are trauma, infection, medication, chronic irritation, viral oncogenes, increased levels of female sex hormones, and microscopic arteriovenous anastomoses. Patients commonly seek treatment because of associated pain or discomfort from ulceration, bleeding, or both. Surgical excision and cryotherapy show best therapeutic outcomes for lobular capillary hemangiomas, although electrodessication, shave excision, imiquimod cream, topical timolol, and sclerotherapy are also used. We report a case of frequent lobular capillary hemangioma development in the setting of von Hippel-Lindau syndrome (VHL) and neurofibromatosis type 1 (NF1), requiring multiple treatment modalities.