Angiolymphoid hyperplasia with eosinophilia

Abstract

A 45 year old male presented with nodular lesions on the pinna for the past 2 years [Figure 1] Biopsy of the nodule showed prominent epitheloid endothelial cells and increased eosinophils and lymphoplasmacyte infiltrate around blood vessels [Figures 2 and 3] Figure 1 Photograph showing multiple nodular lesions in the ear Figure 2 Histopathology photos showing prominent endothelial cells and increased lymphohistiocytic infiltrates around blood vessels (H and E, ×40) Figure 3 Increased lymphohistiocytic infiltrates and eosinophils around blood vessels (H and E, ×40) Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare, benign disease with distinctive histopathological features.[1] It is characterized by single or multiple skin-colored or plum colored nodules or plaques especially in head and neck region. Kimura's disease, the close differential diagnosis, is characterized by larger lesions, subcutaneous nodules with involvement of salivary glands, and regional lymph nodes.[2] The smaller lesions of ALHE usually require no treatment and undergo spontaneous regression, but larger lesions require therapy. Surgical excision, intralesional corticosteroids, and pulsed dye laser therapy are the mainstay of treatment.