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Year : 1998  |  Volume : 64  |  Issue : 3  |  Page : 133-134

Angiolymphoid hyperplasia with eosinophilia

Department of Skin and STD, J.J.M. Medical College, Davangere, Karnataka, India

Correspondence Address:
V Jagannath Kumar
266/6 Kanthi, 4th Main PJ Extension, Davengere - 577002
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Source of Support: None, Conflict of Interest: None

PMID: 20921741

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A 35-year old woman presented with asymptomatic dermal nodules over the scalp of 10- years duration. Histopathological study revealed proliferation of thick walled blood vessels lined by plump endothelium and lymphocyte and eosinophilic infiltrate with blood eosinophilia.

Keywords: ALHE, Nodules, Scalp

How to cite this article:
Kumar V J, Guruprasad K Y. Angiolymphoid hyperplasia with eosinophilia. Indian J Dermatol Venereol Leprol 1998;64:133-4

How to cite this URL:
Kumar V J, Guruprasad K Y. Angiolymphoid hyperplasia with eosinophilia. Indian J Dermatol Venereol Leprol [serial online] 1998 [cited 2020 Jun 2];64:133-4. Available from: http://www.ijdvl.com/text.asp?1998/64/3/133/4670

  Introduction Top

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare, benign disease with distinctive histopathoiogical features.[1] It is characterised by single or multiple skin coloured or plum-coloured nodules or plaques especially in head and neck region, composed of vascular channels with surrounding infiltrate of lymphocytes and eosinophils.[2] The disease was first described by Kimura et al in 1948.[3] Many similar cases have been reported under a variety of names such as ALHE, inflammatory angiomatous nodule, pseudopyogenic granuloma, atypical pyogenic granuloma, papular angioplasia, subcutaneous angioblastic lymphoid hyperplasia with eosinophilia and lymphofolliculosis, intravenous atypical vascular proliferation, histiocytoid haemangioma, and epitheloid haemangioma.[4] We report a case of ALHE, in a 35-year-old woman.

  Case Report Top

A 35-year-old woman presented with multiple discrete nodules over the scalp, of 10 years duration [Figure - 1]

Examination revealed multiple discrete, skin-coloured, smooth surfaced nodules varying in size from 0.5 to 1 cm located on the occiput portion of the scalp. They were firm to soft in consistency, slightly tender, noncompressible, and movable.

There was no associated regional lymphadenopathy. Systemic examination revealed no abnormality. Blood and urinalyis, chest x- ray, ultrasonography of abdomen, and pelvis and ECG were normal except for eosinophilia 10% and absolute eosinophil count of 639 celis/cu.mm. Histopathology reveled normal epidermis. Dermis showed proliferation of thick walled blood vessels lined by plump endothelium [Figure - 2]. There was lymphocytic and eosinophilic infiltrate.

  Discussion Top

ALHE presents usually as papular or nodular lesions over the head and neck.[3] Multiple lesions on the extremities also have been described.[1] At times multiple lesions can form grape-like plaques.[2] The histologic features of dermal lesions in our case, showed proliferation of thick walled blood vessels lined by plump endothelium. There was lymphocytic and eosinophilic infiltrate which matches the description by other authors.[1-3, 5] Etiology is unknown, but antigenic stimulation following insect bites has been postulated.[5] The natural history of lesion is such that if a confident diagnois made on a small lesion, it is reasonable to observe the lesion for 3-6 months and await spontaneous regression. Both surgery and radiotherapy are effective.[5] Intra lesional steroid also is effective.

  References Top

1.Moesner J, Pallesen R, Sorensen B. Angiolymphoid hyperplasia with eosinophilia (Kimura's disease). Arch Dermatol 1981;117:650-653.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2.Ramachandra BV, Suneetha C, Rao GRR, etal. Angiolymphoid hyperplasia with eosinophilia. Indian J Dermatol Venereol Leprol 1994;60:45-56.  Back to cited text no. 2    
3.Grimwood R, Swinehart JM, Aelin JL. Angiolymphoid hyperplasia with eosinophilia. Arch Dermatol 1979; 115:205-207.  Back to cited text no. 3    
4.Chun SI, JI JG. Kimura's disease and angiolymphoid hyperplasia with eosinophilia : Clinical and histopathological differences. J Am Acad Dermatol 1992;27:954-958.  Back to cited text no. 4    
5.Mockie RM. Soft tissue tumours. In : Champion RH., Burton JL. Ebling FJG. Textbook of Dermatology, 5th Edn, Oxford : Blackwell Scientific Publications 1992;2085-2086.  Back to cited text no. 5    


[Figure - 1], [Figure - 2]


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