Mohs micrographic surgery for angiolymphoid hyperplasia with eosinophilia.
BACKGROUND
Angiolymphoid hyperplasia with eosinophilia is a benign vascular proliferation that typically presents on the head and neck. Multiple treatment modalities have been proposed for angiolymphoid hyperplasia with eosinophilia, each with limited success or undesirable side effects. At this time, standard surgical excision is considered the treatment of choice but carries recurrence rates of 33% to 50%.


OBJECTIVE
The objective was to present a case of angiolymphoid hyperplasia with eosinophilia successfully extirpated using Mohs micrographic surgery.


METHODS
A 52-year-old woman presented with an ill-defined solitary plaque of angiolymphoid hyperplasia with eosinophilia within her left conchal bowl that enlarged despite conservative therapy with intralesional and topical corticosteroids. Mohs micrographic surgery using the fresh tissue technique and standard hematoxylin and eosin staining was performed. The characteristic histologic features of angiolymphoid hyperplasia with eosinophilia were readily identifiable on frozen sections and complete extirpation required two stages of micrographically controlled resection.


RESULTS
Resection of angiolymphoid hyperplasia with eosinophilia of the conchal bowl with complete resolution of symptoms and no evidence of clinical recurrence 8 months after surgery.


CONCLUSIONS
Given the high recurrence rates reported for standard excision, Mohs micrographic surgery with complete margin examination should be considered as a treatment option for angiolymphoid hyperplasia with eosinophilia, particularly for lesions with ill-defined margins or in locations where tissue sparing is desirable.
Miller
Christopher J
CJ
Resident in Dermatology, Department of Dermatology, Penn State Milton S.Hershey Medical Centre/Penn State College of Medicine, Hershey, Pennsylvania 17033-0850, USA. cmiller@psu.edu
Ioffreda
Michael D
MD
Ammirati
Christie T
CT
D000796:Angiolymphoid Hyperplasia with Eosinophilia / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D004431:Ear, External; D005260:Female; D006801:Humans; D008875:Middle Aged; D015580:Mohs Surgery; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery