Angiolymphoid Hyperplasia With Eosinophilia‐acquired Port‐wine‐stain–like Lesions: Attempt at Treatment With the Argon Laser

Abstract

An unusual case of angiolymphoid hyperplasia with eosinophilia (ALHE) simulating port-wine stain in a 50-year-old woman is reported. The lesions of ALHE are typically papules or subcutaneous masses that range from light pink to red-brown in color. In addition to the usual histologic findings of ALHE, the biopsy in our patient showed some fibrin-like material and fibrous long-spacing collagen on ultrastructural examination. This unusual lesion necessitates biopsy because the differential diagnosis includes port-wine stain, sarcoidosis, lupus erythematosus, and non-Hodgkin lymphoma (mycosis fungoides). Many different forms of treatment have been attempted for ALHE including radiotherapy, cytotoxic chemotherapy, corticosteroids, and antibiotics. The lesions in our patient responded to argon laser therapy and surgical excision, though there has been recurrence on the border of the treated area. Because laser energy is noncumulative in the tissues and effective in removing the lesions, we recommend it as the treatment of choice for these lesions.

Angiolymphoid Hyperplasia with Eosinophilia of the Hand

“…In over 50% of cases, the lesions are found to be multiple 6,7 . An unusual appearance of the port‐wine‐stain type has also been noted recently 8 …”

“…There appear to be characteristic clinical and pathologic differences between angiolymphoid hyperplasia with eosinophilia as described in the English‐language literature and Kimura's disease as described in Asian literature 8 . Kimura's disease appears in younger patients, shows a male predominance, and has larger and more widely distributed lesions 8,14 . Histologically, Kimura's disease has features of the more follicular or inflammatory phase of angiolymphoid hyperplasia with eosinophilia and is associated much more frequently with a peripheral eosinophilia and regional lymphadenopathy 6,8,13,14,15 .…”

“…There is some controversy regarding the difference between angiolymphoid hyperplasia with eosinophilia and Kimura's disease. There appear to be characteristic clinical and pathologic differences between angiolymphoid hyperplasia with eosinophilia as described in the English‐language literature and Kimura's disease as described in Asian literature 8 . Kimura's disease appears in younger patients, shows a male predominance, and has larger and more widely distributed lesions 8,14 .…”

Collision Dermatosis: Angiolymphoid Hyperplasia with Eosinophilia Developing within a Congenital Port Wine Nevus

“…[8], However, to the best of our knowledge this is the first report on ALHE arising within a congenital port wine stain lesion.…”

Mohs Micrographic Surgery for Angiolymphoid Hyperplasia with Eosinophilia

“…Treatment for angiolymphoid hyperplasia with eosinophilia can be challenging, as evidenced by the number of proposed modalities 8,10–25 (Table 1). Recurrence is common, despite the chosen treatment option.…”