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[Intravascular papillary endothelial hyperplasia: multiple lesions appearing in the course of treatment with
C Durieu1, P Bayle-Lebey, A Gadroy
1Service de Dermatologie, Vénéréologie et Allergologie, CHU Purpan, place du Docteur Baylac, 31059 Toulouse.
Introduction:
Intravascular papillary endothelial hyperplasia is a benign and rare vascular lesion. We report a case of multiple vascular lesions of the hand following 3 months treatment with beta-interferon injections for multiple sclerosis.
Observation:
A 50 year-old man had multiple vascular nodules of the hands. He was treated with beta interferon injections for multiple sclerosis for 3 months. Histology showed typical changes of intravascular papillary endothelial hyperplasia: papillary endothelial proliferation in a dilated cavity associated with thrombosis.
Discussion:
Intravascular papillary endothelial hyperplasia is a benign and rare vascular lesion usually presenting as a simple nodule. It may be painful. Diagnosis is histologic, characterized by papillary endothelial proliferation associated with a thrombus within a vessel. It may be confused with hemangiosarcoma. Treatment is surgical and recurrence after treatment is rare. Intravascular papillary endothelial hyperplasia is generally considered as an unusual form of thrombus organization. Intravascular papillary endothelial hyperplasia is divided into two groups: a pure form occurring within a dilated vessel and a mixed form appearing in benign vascular lesions. The originality of this case is the rarity and the multiplicity of the lesions. The possible pathogenesis of interferon-induced cutaneous vascular lesions is discussed.
Insights
Multiple vascular lesions, a rare condition known as intravascular papillary endothelial hyperplasia, appeared on a patient's hands after beta-interferon treatment for multiple sclerosis. This case highlights a potential side effect of this therapy.
Area of Science:
- Vascular pathology
- Dermatology
- Neurology
Background:
- Intravascular papillary endothelial hyperplasia (IPEH) is a rare, benign vascular proliferation.
- Multiple sclerosis (MS) is a chronic neurological disease often treated with immunomodulatory therapies.
Observation:
- A 50-year-old male presented with multiple vascular nodules on his hands.
- The patient had undergone 3 months of beta-interferon injections for multiple sclerosis.
- Histopathological examination revealed characteristic features of IPEH.
Findings:
- Histology confirmed IPEH, showing papillary endothelial proliferation within a dilated vessel lumen, accompanied by thrombosis.
- The case is notable for the multiplicity and rarity of IPEH lesions in this context.
- Differential diagnosis includes hemangiosarcoma, emphasizing the need for histological confirmation.
Implications:
- This case suggests a potential association between beta-interferon therapy and the development of cutaneous vascular lesions like IPEH.
- Further research into the pathogenesis of interferon-induced vascular lesions is warranted.
- Understanding this association is crucial for managing patients with multiple sclerosis undergoing interferon treatment.
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