Multinucleate cell angiohistiocytoma: Case report and literature review.

Multinucleate cell angiohistiocytoma is a rare, vascular, fibrohistiocytic proliferation that has a benign but progressive course. The clinical presentation is that of grouped red-purple papules and nodules characteristically located on the lower extremities in women. The histopathology shows a proliferation of narrow vessels within thickened collagen bundles associated with multinucleate giant cells. These lesions are probably reactive in nature, and several mechanisms of pathogenesis, including hormonal, have been proposed. Different modalities, including intense pulsed light and pulsed-dye laser, have been used for treatment of these lesions. We report a case of a 74-year-old Caucasian woman with long-standing multinucleate angiohistiocytoma on her bilateral thighs that eluded diagnosis for several years. Upon biopsy and histopathological analysis, the diagnosis was made. Treatment options were entertained, although ultimately not pursued by the patient. We report this case to increase clinical awareness of this rare disease and to contribute to the ongoing literature aimed to further characterize this condition.

Inflammatory linear verrucous epidermal nevus responsive to 308-nm excimer laser treatment.

Inflammatory linear verrucous epidermal nevus (ILVEN) is a rare cutaneous disease that presents as linear psoriasiform plaques with associated prominent pruritus. The lesions commonly pre-sent on the legs with onset during childhood. Inflammatory linear verrucous epidermal nevus typically is refractory to treatment. Therapies range from topical treatments to lasers and surgical options. It is clinically and histopathologically similar to psoriasis, suggesting it may respond to established psoriasis treatments such as the excimer laser. We report the case of an otherwise healthy 20-year-old woman with dry, pruritic, red lesions on the right leg that had been present since infancy. Biopsy revealed psoriasiform hyperplasia with a verruciform surface. Multiple topical treatments including ablative CO2 laser therapy showed no remarkable improvement. The patient was then treated with a UV 308-nm excimer laser and showed noticeable clinical improvement. Because of its clinical and histopathological similarities to psoriasis, we hypothesized that the excimer laser may be useful in the treatment of these lesions.