Angiolymphoid hyperplasia with eosinophilia and Kimura's disease – a clinical and histopathological comparison

Abstract

Summary Angiolymphoid hyperplasia with eosinophilia (ALHE) is a benign vascular neoplasm mainly affecting middle‐aged women. Lesions typically affect the head and neck region. ALHE is considered a distinct disease entity different from Kimura's disease, a benign reactive lymphoid proliferation that is predominantly seen in young Asian men although it can affect all ethnic groups. In contrast to ALHE, Kimura's disease is typically associated with peripheral blood eosinophilia, increased serum IgE and lymphadenopathy. Several case reports suggest an overlap between ALHE and Kimura's disease. We review the current literature and discuss whether AHLE and Kimura's disease might represent two extreme variants of the same disease entity.

Eosinophilia in Dermatologic Disorders

“…Kimura's disease (KD) is a benign reactive lymphoid proliferation, characterized by deep subcutaneous and intramuscular swellings and regional lymphadenopathy predominantly seen in young Asian men. 61 ALHE shares similarities with KD lesions predominantly in the head-neck region, benign and recurrent disease course, and eosinophil-rich lymphoid hyperplasia. 61 In contrast with de Graauw et al AHLE, KD is associated typically with peripheral blood eosinophilia, increased serum IgE levels, and lymphadenopathy.…”

“…61 ALHE shares similarities with KD lesions predominantly in the head-neck region, benign and recurrent disease course, and eosinophil-rich lymphoid hyperplasia. 61 In contrast with de Graauw et al AHLE, KD is associated typically with peripheral blood eosinophilia, increased serum IgE levels, and lymphadenopathy. Although the cause of both ALHE and KD is not known, the localization of lesions, lymphoid infiltration, and the presence of eosinophils are suggestive of a reactive reaction possibly to an infectious agent.…”

“…60 Angiolymphoid hyperplasia with eosinophilia and Kimura's disease Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare disease presenting with unilateral erythematous papules and nodules predominantly in middle-aged woman. 61 Histologic examination shows an increased number of blood vessels with proliferation of endothelial cells possessing pathognomonic cytoplasmic vacuoles and a diffuse lymphocytic infiltrate with eosinophils. Kimura's disease (KD) is a benign reactive lymphoid proliferation, characterized by deep subcutaneous and intramuscular swellings and regional lymphadenopathy predominantly seen in young Asian men.…”

“…Although the cause of both ALHE and KD is not known, the localization of lesions, lymphoid infiltration, and the presence of eosinophils are suggestive of a reactive reaction possibly to an infectious agent. 61 Primary cutaneous CD30 1 lymphoproliferative disorders: lymphomatoid papulosis and primary cutaneous anaplastic large-cell lymphoma Characteristically, lymphomatoid papulosis (LYP) follows a chronic disease course with recurrent development of papulonodular lesions that undergo spontaneous regression after weeks or months (see Fig. 5B).…”

Diagnostically Challenging Epithelioid Vascular Tumors

“…1 Epithelioid hemangiomas most commonly present on the head and neck, often in a periauricular location, in middle-aged adults with a female predominance. 2,3 However, a wide range of cutaneous locations may be involved. [4][5][6][7][8][9] They clinically and grossly appear as small erythematous nodules or plaques, commonly with ulceration or excoriation, and commonly as multiple coalescing lesions.…”