Angiolymphoid hyperplasia with eosinophilia: Difference between revisions

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== Natural History, Complications and Prognosis==
== Natural History, Complications and Prognosis==
*The majority of patients with [disease name] remain asymptomatic for
*The majority of patients with angiolymphoid hyperplasia with eosinophilia remain asymptomatic for several years.
[duration/years].
*Common complications of angiolymphoid hyperplasia with eosinophilia include pruritis, pulsation, and spontaneous bleeding.
*Early clinical features include [manifestation 1], [manifestation 2],
*Prognosis is generally [excellent/good/poor], and the [1/5/10year mortality/survival rate] of patients with [disease name] is approximately [#%].
and [manifestation 3].
 
*If left untreated, [#%] of patients with [disease name] may progress
to develop [manifestation 1], [manifestation 2], and [manifestation
3].
*Common complications of [disease name] include [complication 1],
[complication 2], and [complication 3].
*Prognosis is generally [excellent/good/poor], and the [1/5/10year
mortality/survival rate] of patients with [disease name] is
approximately [#%].
== Diagnosis ==
== Diagnosis ==
=== Symptoms ===
=== Symptoms ===

Revision as of 20:05, 9 May 2016

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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

Overview

Angiolymphoid hyperplasia with eosinophilia [1] 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.[2]

Historical Perspective

  • Angiolymphoid hyperplasia with eosinophilia was first discovered by G. C. WELLS andI. W. WHIMSTER, two british physicians , in 1969.[3]

Pathophysiology

  • 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 (ALHE) is a rare and idiopathic vascular disorder.
  • Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon benign lesion, primarily occurring in the head and neck.
  • On gross pathology, smooth-surface red to brown papules or nodules on the head, neck, trunk, extremities, genitalia, lips and oral mucosa; extracutaneous involvement 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

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

Differentiating Angiolymphoid hyperplasia with eosinophilia from other Diseases

  • Angiolymphoid hyperplasia with eosinophilia must be differentiated from other diseases that cause swelling of face and neck, such as:
  • Kimura’s disease
  • Acial granuloma
  • Insect bite reaction
  • Cutaneous lymphoma
  • Sarcoidosis

Epidemiology and Demographics

  • The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
  • In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].

Age

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

Gender

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

Race

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

Risk Factors

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

Natural History, Complications and Prognosis

  • 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.
  • Prognosis is generally [excellent/good/poor], and the [1/5/10year mortality/survival rate] of patients with [disease name] is approximately [#%].

Diagnosis

Symptoms

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

Physical Examination

  • Physical examination may be remarkable for:
  • [finding 1]
  • [finding 2]
  • [finding 3]
  • [finding 4]
  • [finding 5]
  • [finding 6]

Laboratory Findings

  • There are no specific laboratory findings associated with [disease

name].

  • A [positive/negative] [test name] is diagnostic of [disease name].
  • An [elevated/reduced] concentration of

[serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].

  • Other laboratory findings consistent with the diagnosis of [disease

name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Imaging Findings

  • There are no [imaging study] findings associated with [disease name].
  • [Imaging study 1] is the imaging modality of choice for [disease

name].

  • On [imaging study 1], [disease name] is characterized by [finding 1],

[finding 2], and [finding 3].

  • [Imaging study 2] may demonstrate [finding 1], [finding 2], and

[finding 3].

Other Diagnostic Studies

  • [Disease name] may also be diagnosed using [diagnostic study name].
  • Findings on [diagnostic study name] include [finding 1], [finding 2],

and [finding 3].

Treatment

Medical Therapy

  • The mainstay of therapy for angiolymphoid hyperplasia with eosinophilia is intralesional corticoid therapy and imiquimod.
  • Imiquimod acts by induction of the production of interferon-α and induction or inhibition of certain cytokines, mainly interleukin-5.[4]

Surgery

  • Surgery is the mainstay of therapy for angiolymphoid hyperplasia with eosinophilia.
  • Mohs micrographic surgery with complete margin examination is performed.
  • Other treatment options include radiotherapy, curettage, shave excision with electrodessication, cryotherapy, corticosteroids (topical, systemic or intralesional preparation), and laser therapy using Continuous wave carbon dioxide and argon lasers.[5]

Prevention

  • There are no primary preventive measures available for [disease

name].

  • Effective measures for the primary prevention of [disease name]

include [measure1], [measure2], and [measure3].

  • Once diagnosed and successfully treated, patients with [disease name]

are followedup every [duration]. Followup testing includes [test 1], [test 2], and [test 3].

Diagnosis

Ear

References

  1. Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
  2. James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
  3. Wells GC, Whimster IW (1969). "Subcutaneous angiolymphoid hyperplasia with eosinophilia". Br J Dermatol. 81 (1): 1–14. PMID 5763634.
  4. Esteves, Paola; Barbalho, Marcella; Lima, Tiago; Quintella, Leonardo; Niemeyer-Corbellini, Jo�o Paulo; Ramos-e-Silva, Marcia (2015). "Angiolymphoid Hyperplasia with Eosinophilia: A Case Report". Case Reports in Dermatology. 7 (2): 113–116. doi:10.1159/000381843. ISSN 1662-6567. replacement character in |first5= at position 3 (help)
  5. Lembo S, Balato A, Cirillo T, Balato N (2011). "A Long-Term Follow-Up of Angiolymphoid Hyperplasia with Eosinophilia Treated by Corticosteroids: When a Traditional Therapy is Still Up-to-Date". Case Rep Dermatol. 3 (1): 64–7. doi:10.1159/000323182. PMC 3073756. PMID 21487464.