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epithelioid hemangioma; angiolymphoid hyperplasia with eosinophilia
Epidemiology:
- uncommon
- more frequent in women than men
- median age of onset = 30 years, range: 20-50 years
Pathology:
- benign neoplasm
- generally located in the dermis or subcutaneous tissue
- less commonly located in deep soft tissues
- blood vessels in periphery well formed. less so in center of lesion
- projections into the vascular lumen
- neoplastic blood vessels accompanied by variable inflammatory infiltrate of lymphocytes, eosinophils, mast cells & plasma cells
Clinical manifestations:
- isolated or grouped papules, plaques, or nodules
- occurs in the skin of the head & neck, most commonly in the periauricular skin, forehead, & scalp
- isolated lesion 0.5-2.0 cm in diameter (80%)
- pruritus, pain, bleeding common
Laboratory:
- complete blood count (CBC): eosinophilia
Differential diagnosis:
- Kimura's disease
Management:
- spontaneous resolution is rare
- medical therapy not curative
- intralesional injections of
- glucocorticoids
- interferon alfa-2b
- topical treatment with imiquimod or tacrolimus
- systemic glucocorticoids, isotretinoin, or mepolizumab
- surgical options
- laser therapy
- cryosurgery
- electrosurgery
- Mohs micrographic surgery
General
hemangioma (strawberry nevus)
References
- Stankovic KM, Tan OT, Sadow PM.
Case 36-2015 - A 27-Year-Old Woman with a Lesion of the Ear
Canal.
N Engl J Med. 2015 Nov 19;373(21):2070-7.
PMID: 26581000
http://www.nejm.org/doi/full/10.1056/NEJMcpc1410941