Angiolymphoid hyperplasia with eosinophilia: successful treatment with the Nd:YAG laser.

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon idiopathic proliferation of blood vessels that manifests in adults as isolated or grouped papules, plaques, or nodules in the skin of the head and neck. We describe the case of a 31-year-old woman with a 3-year history of persistent ALHE, located on the tragus of her right ear, with no sign of spontaneous regression over a period of 3-6 months and refractory to intralesional corticosteroids. We report the successful use of the Nd:YAG laser for this condition, which offered excellent symptomatic and cosmetic results and suggests the consideration of this modality in the treatment of ALHE.     

Angiolymphoid hyperplasia with eosinophilia. Histologic study and successful therapy with the argon laser

We report a case of angiolymphoid hyperplasia with eosinophilia (AHE) with regional lymphadenopathy. The multiple papules were composed of both a lymphoid infiltrate of predominant T-cell type with eosinophils and anomalous vascular proliferation lined by "histiocytoid" endothelial cells, which were in close association with a ruined artery at the subcutaneous level in the largest nodule. Immunoelectron microscopy revealed factor-VIII-related antigen to be concentrated within the Weibel-Palade bodies of the endothelial cells. Their cytoplasmic filaments consisted of vimentin. In the pericytes large amounts of actin were demonstrable. Since AHE has a benign progressive course and only local recurrence is noted, the lesions were treated with argon laser. Subsequently, lymphadenopathy resolved spontaneously and the blood parameters normalized. There is no evidence of recurrence 1 year after treatment.     

Angiolymphoid hyperplasia with eosinophilia of the nail bed and bone: successful treatment with radiation therapy

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare entity characterized by the presence of one or several papules or nodules in the skin. Histopathology of ALHE shows a marked proliferation of blood vessels with distinctive large endothelial cells and variable inflammatory infiltrates with eosinophils. We report a 32-year-old Caucasian woman with multiple nodules involving the skin, subcutaneous tissue and bone of the distal phalanx of the fingers that were treated successfully with orthovoltage radiation therapy (40 Gy/20 fractions) and without any side-effects after 9 years of follow-up.     

Angiolymphoid hyperplasia with eosinophilia: Successful treatment with the Nd:YAG laser

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon idiopathic proliferation of blood vessels that manifests in adults as isolated or grouped papules, plaques, or nodules in the skin of the head and neck. We describe the case of a 31‐year‐old woman with a 3‐year history of persistent ALHE, located on the tragus of her right ear, with no sign of spontaneous regression over a period of 3–6 months and refractory to intralesional corticosteroids. We report the successful use of the Nd:YAG laser for this condition, which offered excellent symptomatic and cosmetic results and suggests the consideration of this modality in the treatment of ALHE.     

Angiolymphoid hyperplasia, a successfully treated case

Recurrent nodules on the face of a 37-year-old man, clinically and histologically diagnosed as angiolymphoid hyperplasia with eosinophilia, promptly disappeared on intralesional infiltration of hydroxypolyethoxydodecan, although his eosinophilia and elevated level of IgE continued.     

Angiolymphoid hyperplasia with eosinophilia: good response to photodynamic therapy

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon benign vascular disease of unknown pathogenesis, that occurs as solitary or multiple nodules or papules. Lesions are located mainly on the head, forehead and neck, and may be persistent and difficult to eradicate. We report a case of ALHE treated with aminolaevulinic acid photodynamic therapy (ALA‐PDT). Treatment consisted of two ALA‐PDT sessions with a 2‐week interval. Clinical evaluation, 8 weeks after treatment, showed marked improvement though not complete regression. The treatment was well tolerated. At follow‐up 4 months after treatment, the lesions were stable. We believe that PDT could be an alternative therapeutic approach for ALHE or could be used as a neoadjuvant treatment to reduce lesion size especially where size or site of lesions limits the efficacy or acceptability of other treatments. The lack of cumulative effects allows repeated treatments with ALA‐PDT, but long‐term follow‐up is advised for assessment of recurrence.     

Multifocal papillomavirus epithelial hyperplasia: successful treatment with CO2 laser therapy combined with interferon alpha-2b

Human papilloma virus (HPV) infections of the oral mucosa presents with various clinical and histopathologic features in relation with the causative HPV type and chronicity and the extent of the infection.1 The entity is known by several names based on histopathologic variations such as focal epithelial hyperplasia, oral florid papillomatosis, verrucous hyperplasia, oral florid verrucosis, and Ackerman's tumor. In recent years, the term multifocal papillomavirus epithelial hyperplasia (MPVEH) has been proposed to define the variant that usually occurs in childhood and is characterized by diffuse confluent papillomatous lesions in the oral mucosa.1 Despite the lesions' benign appearance, early diagnosis and therapy of MPVEH is essential because of its high capacity for progression and its tendency for malign degeneration.     

Angiolymphoid hyperplasia with eosinophilia affecting the scrotum: A rare case report with molecular evidence of T‐cell clonality

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare, benign entity of unknown pathogenesis. It often presents as painful or pruritic intradermal or subcutaneous red to brown papules or nodules on the head and neck of young adults. A 38‐year‐old man had a gradually enlarging and mild pruritic plaque on the scrotum for half a year. Pathological findings showed dermal proliferation of anomalous blood vessels lined by plump endothelium with a significant perivascular inflammatory infiltrate composed of lymphocytes, histiocytes, scattered plasma cells and many eosinophils. They were consistent with the diagnosis of ALHE. In addition, the inflammatory infiltrate was analyzed by immunohistochemistry and T‐cell receptor (TCR) gene rearrangement. They were mostly CD3⁺ T cells and a monoclonal T‐cell population. To the best of our knowledge, this is the first case of ALHE affecting the scrotum to be reported in the published work. We present this case to expand the anatomical distribution of this rare tumor. The molecular study of our case supports that ALHE might be a low‐grade T‐cell lymphoproliferative disorder.     

Angiolymphoid hyperplasia with eosinophilia and Kimura disease overlap,with evidence of diffuse visceral involvement

A relationship between Kimura disease (KD) and angiolymphoid hyperplasia with eosinophilia (ALHE) has been debated. Given substantial clinical and histological overlap, these entities were once considered to represent a disease spectrum; however, they are now widely considered to be nosologically distinct. A diagnosis of either condition is further complicated by resemblance to various malignancies, which must be carefully excluded. Coexistence of ALHE and KD in a patient is extremely rare, with only four cases reported in the English literature. We report what is to our knowledge the first case of ALHE and KD overlap with evidence of diffuse visceral involvement.     

Angiolymphoid hyperplasia with eosinophilia and nephrotic syndrome

A 45-year-old woman from Afghanistan presented with a 1-year history of multiple itching and stinging lesions on both right and left auricular and periauricular areas. Skin examination revealed about eight superficial erythematous nodules, ranging from 0.2 to 1.2 cm in diameter, on both ears, as well as on the preauricular and retroauricular areas ( Fig. 1 ).

Figure 1 Open in figure viewer PowerPoint Multiple erythematous nodules and papules on the left auricular and periauricular areas     

Angiolymphoid hyperplasia with eosinophilia successfully treated with imiquimod. A case report

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare disorder characterized by vascular proliferation, eosinophilia in peripheral blood samples and lymphocytosis. The etiology is unknown; this rare condition is generally seen in women. It often presents as multiple, grouped red nodules in the periauricular region, scalp line and neck. Numerous therapeutic approaches have been tried for ALHE including destructive techniques such as electrodesiccation, cryotherapy, surgical excision, radiotherapy or laser (argon, CO(2), pulse dye). We present an ALHE case that was treated successfully by using topical imiquimod cream.     

Angiolymphoid hyperplasia with eosinophilia affecting the oral mucosa: report of a case and a review of the literature

Summary Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon disorder of unknown aetiology. Clinically, it is characterized by cutaneous papules or nodules on the head and neck and extra cutaneous involvement is rare. We report a 30-year-old woman who had an asymptomatic submucosal nodule on the upper lip, which histopathological showed features of ALHK and review the previously described 15 cases of oral ALHE.     

Angiolymphoid hyperplasia with eosinophilia developing within a port wine stain

A 19‐year‐old male with a port wine stain on the base of his neck presented with a 5‐month history of gradual thickening of the involved skin which interfered with clothing and caused repeated bleeding. The lesion was excised and histopathologic examination revealed angiolymphoid hyperplasia with eosinophilia (ALHE) arising from the pre‐existing port wine stain – a rare finding with only one previously reported case. Additionally the lesion was associated with elevated serum renin levels which virtually normalized following excision of the lesion. We further demonstrated the expression of angiotensin converting enzyme and angiotensin II receptors 1 and 2 by the lesion and discuss the possible role of the renin–angiotensin system in this condition.