Intralesional Bleomycin for Angiolymphoid Hyperplasia

A 51-year-old woman presented with a 4-year history of slightly pruritic, bleeding papules on her right ear. Approximately 2 years earlier, the lesions had been excised, but they had recurred the following year and had increased in number within the past 3 months. The dermatologic examination revealed 5 violaceous, erythematous soft papules ranging from 3 mm to 1 cm in diameter in the helix and on the upper lateral postauricular region of the right ear (Figure 1). The results of the systemic examination were normal, without evidence of lymphadenopathy. Routine laboratory tests, including a complete blood cell count, erythrocyte sedimentation rate, routine blood biochemical profile, complete urinalysis, IgE level, antistreptolysin-O and C-reactive protein assessments, and x-ray imaging of the chest, demonstrated no abnormalities. Histopathologic examination of a punch biopsy specimen revealed angiolymphoid hyperplasia with eosinophilia (ALHE) (Figure 2).