Angiolymphoid hyperplasia with eosinophilia L98.9

Multicentric, benign lymphoproliferative hyperplasia, clinically characterized by dermal nodules and nodules, but also by subcutaneously located nodules with edema, lymphocytic and eosinophilic infiltrates, formation of germinal centers, fibrosis, and hyperplasia of blood vessels. Most authors separate Kimura's disease from angiolymphoid hyperplasia with eosinophilia on the basis of clinical and histological criteria. Obviously, overlaps of both syndromes are observed. However, the separate entity appears to be secure.

Panethnic among men and women of all ages. Unlike M. Kimura, no preference for the Asian population.

Head, especially ear region, orbita, forehead and capillitium, neck; more rarely extremities and genital area, vulva or penis.

In Kimura's disease, the scalp and neck region are preferentially affected.

Solitary, rarely grouped in plural, asymptomatic or painful, also pruritic, red or brown-red, brown, firm, about 0.5-0.8cm in size, papules and nodules with a smooth surface. Also appearing as deep nodules.

Solitary or multiple, 2-40 mm, hemispherical, red, to reddish-brown, rarely purplish or ulcerated nodules and nodules. Rarely disseminated appearance or lymphadenopathy. Usually asymptomatic or painful, also pruritic (pruritus is absent in Kimura's disease!). In Kimura's disease, larger subcutaneous (also intramuscular) non-pruritic nodules are observed.

Atheroma; epidermal cysts; cylindroma; hemangioma; granuloma teleangiectaticum; angiosarcoma; Kaposi's sarcoma; granuloma eosinophilicum faciei; lymphadenosis cutis benigna.

These are individual case reports. Larger experiences are not available due to the rarity of the disease.

Excision in case of longer duration. Risk of recurrence! Risk of bleeding!

CO2 laser may also be used.

Recurrence treatment in patients > 65 years, if necessary with X-rays (GD: 20-30 Gy). Combinations of CO2 laser irradiation with intralesional glucocorticoid application such as triamcinolone acetonide crystal suspension (e.g. Volon A diluted 1:3 with a local anaesthetic, e.g. Scandicaine) have also been described as successful.

1. Abrahamson TG et al (2003) Angiolymphoid hyperplasia with eosinophilia responsive to pulsed dye laser. J Am Acad Dermatol 49: S195-196
2. Asadi AK et al (2002) Angiolymphoid hyperplasia with eosinophilia. Dermatol Online J 8: 10
3. Bangal S et al (2011) Orbital extension of supraorbital angiolymphoid hyperplasia with eosinophilia. Australas Med J 4:111-113.
4. Becker-Weimann SY (2017) Angiolymphoid hyperplasia with eosinophilia. Act Dermatol 44: 468-469
5. Hussain JA et al (2018) Angiolymphoid hyperplasia with eosinophilia (epithelioid hemangioma) of the external auditory canal, an unusual presentation in an adult female: a case report. J Surg Case Rep 2018(7):rjy145.
6. Kempf W et al (2002) Angiolymphoid hyperplasia with eosinophilia: evidence for a T-cell lymphoproliferative origin. Hum Pathol 33: 1023-1029
7. Kim SM et al (2010) Angiolymphoid hyperplasia with eosinophilia on the palm. Ann Dermatol 22:358-361 Ill.)
8. Kurihara Y et al (2012) Epithelioid hemangioma (angiolymphoid hyperplasia with eosinophilia) in zosteriform distribution. Indian J Dermatol 57:401-403.
9. Mukherjee B et al (2015) Angiolymphoid hyperplasia with eosinophilia of the orbit and adnexa. Ocul Oncol Pathol 2:40-47.
10. Santosa C et al (2018) Angiolymphoid hyperplasia with eosinophilia with clinical pictures of keratoacanthoma: A rare case report. Clin Case Rep. 2018 Dec 4;7(1):189-192.
11. Tsuboi H et al (2001) Angiolymphoid hyperplasia with eosinophilia in the oral mucosa. Br J Dermatol 145: 365-366
12. Wells GC, Whimster IW (1969) Subcutaneous angiolymphoid hyperplasia with eosinophilia. Br J Dermatol 81: 1-14