Fractional Erbium-Doped Yttrium Aluminum Garnet Laser 2940 nm-Assisted Delivery of Topical Timolol Solution for the Treatment of Histiocytoid Hemangioma

The document reports a case where a 35-year-old pregnant woman with angiolymphoid hyperplasia with eosinophilia (ALHE), also known as histiocytoid hemangioma, was successfully treated using a combination of fractional erbium-doped yttrium aluminum garnet (Er-YAG) laser 2940 nm and topical 0.05% timolol maleate solution. The patient presented with multiple reddish-brown papulonodules on the right postauricular region, which did not change in size or number post-delivery. Initial treatment with topical timolol alone showed modest improvement, prompting the addition of laser-assisted drug delivery (LADD). After five weekly laser sessions, significant clinical improvement and complete clearance of the lesions were observed. The patient remained disease-free at the nine-month follow-up. This case suggests that the combination of fractional Er-YAG laser and topical timolol is a promising non-invasive treatment for ALHE, warranting further studies.