Angiolymphoid hyperplasia with eosinophilia

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2] Ammu Susheela, M.D. [3]

Synonyms and Keywords: Epithelioid hemangioma; Histiocytoid hemangioma; Inflammatory angiomatous nodule; Intravenous atypical vascular proliferation; Papular angioplasia; Inflammatory arteriovenous hemangioma; Pseudopyogenic granuloma; ALHE; EH

Overview[edit | edit source]

Angiolymphoid hyperplasia with eosinophilia was first discovered by G. C. Wells and I. W. Whimster, two British physicians, in 1969.^[1]Angiolymphoid hyperplasia with eosinophilia ^[2] is defined as red-brown, dome-shaped, dermal papule or nodule, present in the around the ears, scalp, neck, trunk, extremities, genitalia, lips and oral mucosa.^[3]On gross pathology, smooth-surface red to brown papules or nodules are characteristic findings of angiolymphoid hyperplasia with eosinophilia. On microscopic histopathological analysis, florid vascular proliferation with atypical endothelial cells surrounded by a lymphocytic and eosinophilic infiltrate are characteristic findings of angiolymphoid hyperplasia with eosinophilia. Angiolymphoid hyperplasia with eosinophilia may be caused by either allergic reactions, traumas, or autoimmune disorders. Angiolymphoid hyperplasia with eosinophilia must be differentiated from other diseases that cause swelling of face and neck, such as Kimura disease, acial granuloma, insect bite reaction, cutaneous lymphoma, sarcoidosis. The prevalence of angiolymphoid hyperplasia with eosinophilia is unknown as it is an extremely rare disease. Angiolymphoid hyperplasia with eosinophilia is more commonly observed among young patients. Females are more commonly affected with angiolymphoid hyperplasia with eosinophilia than males. Angiolymphoid hyperplasia with eosinophilia usually affects predominently individuals of the Asian race. Common complications of angiolymphoid hyperplasia with eosinophilia include pruritis, pulsation, and spontaneous bleeding. Findings on biopsy include proliferation of small blood vessels with endothelial cells having a cobblestone appearance, a perivascular and interstitial infiltrate of lymphocytes and eosinophils. Surgery is the mainstay of therapy for angiolymphoid hyperplasia with eosinophilia.

Historical Perspective[edit | edit source]

• Angiolymphoid hyperplasia with eosinophilia was first discovered by G. C. Wells and I. W. Whimster, two British physicians, in 1969.^[1]

Pathophysiology[edit | edit source]

• Angiolymphoid hyperplasia with eosinophilia ^[4] is defined as red-brown, dome-shaped, dermal papule or nodule, present in the head or neck, specifically around the ears and on the scalp.^[3]
• The pathogenesis of angiolymphoid hyperplasia with eosinophilia is characterized by red to brown papules or nodules dislocated in the dermis or subcutaneous tissue.
• Angiolymphoid hyperplasia with eosinophilia is a rare and idiopathic vascular disorder.
• On gross pathology, smooth-surface red to brown papules or nodules on the head, neck, trunk, extremities, genitalia, lips and oral mucosa are characteristic findings of angiolymphoid hyperplasia with eosinophilia.
• On microscopic histopathological analysis, florid vascular proliferation with atypical endothelial cells surrounded by a lymphocytic and eosinophilic infiltrate are characteristic findings of angiolymphoid hyperplasia with eosinophilia.

Causes[edit | edit source]

• Angiolymphoid hyperplasia with eosinophilia may be caused by either allergic reactions, traumas, or autoimmune disorders.

Differentiating Angiolymphoid hyperplasia with eosinophilia from other Diseases[edit | edit source]

• Angiolymphoid hyperplasia with eosinophilia must be differentiated from other diseases that cause swelling of face and neck, such as:

• Kimura disease
• Acial granuloma
• Insect bite reaction
• Cutaneous lymphoma
• Sarcoidosis

Epidemiology and Demographics[edit | edit source]

• The prevalence of angiolymphoid hyperplasia with eosinophilia is unknown as it is an extremely rare disease.

Age[edit | edit source]

• Angiolymphoid hyperplasia with eosinophilia is more commonly observed among young patients.

Gender[edit | edit source]

• Females are more commonly affected with angiolymphoid hyperplasia with eosinophilia than males.

Race[edit | edit source]

• Angiolymphoid hyperplasia with eosinophilia usually affects predominently individuals of the Asian race.

Risk Factors[edit | edit source]

• Common risk factors in the development of angiolymphoid hyperplasia with eosinophilia are allergic reactions, traumas or autoimmune disorders.

Natural History, Complications and Prognosis[edit | edit source]

• The majority of patients with angiolymphoid hyperplasia with eosinophilia remain asymptomatic for several years.
• Common complications of angiolymphoid hyperplasia with eosinophilia include pruritis, pulsation, and spontaneous bleeding.
• One-third of cases of angiolymphoid hyperplasia with eosinophilia recur when incompletely excised.

Diagnosis[edit | edit source]

Symptoms[edit | edit source]

• Angiolymphoid hyperplasia with eosinophilia lesions may be asymptomatic, painful or pruriginous.

Physical Examination[edit | edit source]

• Physical examination may be remarkable for:

• Dome-shaped, smooth-surfaced papules or expanding nodule or group of nodules

Ear[edit | edit source]

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  Epithelioid hemangioma. Adapted from Dermatology Atlas.<ref name="Dermatology Atlas">{{Cite

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  Epithelioid hemangioma. Adapted from Dermatology Atlas.<ref name="Dermatology Atlas">{{Cite

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  Epithelioid hemangioma. Adapted from Dermatology Atlas.<ref name="Dermatology Atlas">{{Cite

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  Epithelioid hemangioma. Adapted from Dermatology Atlas.<ref name="Dermatology Atlas">{{Cite

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  Epithelioid hemangioma. Adapted from Dermatology Atlas.<ref name="Dermatology Atlas">{{Cite

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  Epithelioid hemangioma. Adapted from Dermatology Atlas.<ref name="Dermatology Atlas">{{Cite

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  Epithelioid hemangioma. Adapted from Dermatology Atlas.<ref name="Dermatology Atlas">{{Cite

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  Epithelioid hemangioma. Adapted from Dermatology Atlas.<ref name="Dermatology Atlas">{{Cite

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  Epithelioid hemangioma. Adapted from Dermatology Atlas.<ref name="Dermatology Atlas">{{Cite

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  Epithelioid hemangioma. Adapted from Dermatology Atlas.<ref name="Dermatology Atlas">{{Cite