Disseminated angiolymphoid hyperplasia with eosinophilia successfully treated with levamisol

Epidemiology and treatment of angiolymphoid hyperplasia with eosinophilia (ALHE): A systematic review

BACKGROUND

Current knowledge of angiolymphoid hyperplasia with eosinophilia (ALHE) derives from retrospective reports and case series, leading to a nonevidence-based treatment approach.

OBJECTIVE

We sought to systematically review the literature relating to cutaneous ALHE to estimate its epidemiology and treatment outcomes.

METHODS

A literature search of PubMed, EMBASE, Web of Science, and Google Scholar was conducted. Articles detailing cases of histologically confirmed cutaneous ALHE were included.

RESULTS

In all, 416 studies were included in the review, representing 908 patients. There was no sex predominance among patients with ALHE. Mean age at presentation was 37.6 years. There was a significant association between presence of multiple lesions and pruritus, along with bleeding. Surgical excision was the most commonly reported treatment for ALHE. Treatment failure was lowest for excision and pulsed dye laser. Mean disease-free survival after excision was 4.2 years. There were higher rates of recurrence postexcision with earlier age of onset, longer duration of disease, multiple lesions, bilateral lesions, pruritus, pain, and bleeding.

LIMITATIONS

Potential for publication bias is a limitation.

CONCLUSIONS

Surgical excision appears to be the most effective treatment for ALHE, albeit suboptimal. Pulsed dye and other lasers may be effective treatment options. More studies are needed to improve the treatment of ALHE.

Angiolymphoid hyperplasia with eosinophilia: Successful treatment with the Nd:YAG laser

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon idiopathic proliferation of blood vessels that manifests in adults as isolated or grouped papules, plaques, or nodules in the skin of the head and neck. We describe the case of a 31-year-old woman with a 3-year history of persistent ALHE, located on the tragus of her right ear, with no sign of spontaneous regression over a period of 3-6 months and refractory to intralesional corticosteroids. We report the successful use of the Nd:YAG laser for this condition, which offered excellent symptomatic and cosmetic results and suggests the consideration of this modality in the treatment of ALHE.