A case of angiolymphoid hyperplasia with eosinophilia treated with intralesional interferon alfa-2a.

A 52-year-old white woman presented with a 1-year history of pruritic, erythematous nodules on her right ear and preauricular area (Figure 1). The lesions had a tendency to bleed after minor trauma and had been gradually increasing in size and number. A biopsy was performed, and the findings were consistent with the diagnosis of angiolymphoid hyperplasia with eosinophilia (ALHE). The patient was initially treated with a combination of intralesional triamcinolone acetonide and cryosurgery, at 1to 4-month intervals. The triamcinolone acetonide therapy was started with 1 to 2 mL intralesionally at 5 mg/mL, and the concentration was gradually increased to 20 mg/mL. The patient’s response was variable, with improvement seen at some visits and worsening noted at others. After 11⁄2 years, and continued progression of lesions, new therapeutic options needed to be considered.