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*The pathogenesis of angiolymphoid hyperplasia with eosinophilia is characterized by  red to brown papules or nodules dislocated in the dermis or subcutaneous tissue.
*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.
* 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; extracutaneous involvement are characteristic findings of angiolymphoid hyperplasia with eosinophilia.
*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.
*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==
==Causes==

Revision as of 20:28, 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; EH

Overview

Historical Perspective

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

Pathophysiology

  • Angiolymphoid hyperplasia with eosinophilia [2] 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

  • 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.
  • One-third of cases of angiolymphoid hyperplasia with eosinophilia recur when incompletely excised.

Diagnosis

Symptoms

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

Physical Examination

  • Physical examination may be remarkable for:
  • Dome-shaped, smooth-surfaced papules or expanding nodule or group of nodules

Ear

Laboratory Findings

  • A eosinophilia in CBC is charecteristic of angiolymphoid hyperplasia with eosinophilia.
  • Eosinophils in urinalysis is also a feature.

Other Diagnostic Studies

  • Angiolymphoid hyperplasia with eosinophilia may also be diagnosed using biopsy.
  • 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.

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 angiolymphoid hyperplasia with eosinophilia

References

  1. Wells GC, Whimster IW (1969). "Subcutaneous angiolymphoid hyperplasia with eosinophilia". Br J Dermatol. 81 (1): 1–14. PMID 5763634.
  2. Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
  3. James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
  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.