Back issues No.3 - 2004 / Resident Forum  

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Persistent facial angioedema
Mei-Chin Ho , Ming-Tuo Chuan , Shu-Ling Hu
Dermatol Sinica 22 : 266-267, 2004

The 61-year-old male had peripheral vascular occlusive disease and hypertension under medical control. He had no allergic history of drug and food. He presented with asymptomatic facial edema for more than 4 months. The edema began at forehead then extended to eyelids and bilateral cheeks as well as scalp (Fig. 1). No response to antihistamine and diuretics were also noted. Laboratory data showed BUN: 21 mg/dl, Cr: 0.8 mg/dl, urinalysis: no proteinuria, C3: 119 mg/dl, C4: 22.1 mg/dl and ANA: negative. The cardiac sonography showed no abnormality. The sonography of renal vein and jugular vein revealed no stenosis. The carotid color duplex showed normal extracranial vascular ultrasonography study and no significant stenosis of the intracranial arteries. The skin biopsy over his left cheek was performed and the histopathology of the tissue specimen was shown as follows (Fig. 2, 3). The tumor cells revealed positive for CD34 and Ulex europaeus lectin 1 (Fig. 4), but negative for factor VIII and cytokeratin.

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