Ablative Carbon Dioxide Laser as a Therapeutic Option for Multinucleated Cell Angiohistiocytoma

Multinucleated cell angiohistiocytoma (MCAH) is a rare and benign cutaneous proliferation of vascular and histiocytic elements, predominantly affecting the dorsal aspects of acral regions. Clinically, it presents as multiple, flat-topped, violaceous papules that are typically asymptomatic and unilateral, although bilateral cases have been reported. Dermoscopic examination often reveals a fine, whitish reticulated pattern within a violaceous background. Histopathologically, MCAH is characterized by a proliferation of small dermal vessels accompanied by multinucleated cells within a sclerotic stroma. The etiology remains uncertain, but it is generally considered a reactive process. Various treatment modalities have been previously reported with variable success. We report a case of bilateral MCAH in a 56-year-old man, successfully treated with an ablative carbon dioxide laser, resulting in significant lesion reduction and high patient satisfaction.