A 38-Year-Old Woman with Nodular Lesions and a Persistent Pruritus of the Scalp

Abstract

Angiolymphoid hyperplasia with eosinophilia is an uncommon benign vascular and inflammatory disorder. It is not clear whether the disease is primarily a vascular neoplasm, a lymphoproliferative process or hypersensitivity reaction. Angiolymphoid hyperplasia with eosinophilia typically affects adults. It presents as a single nodule or a group of several red-brown or violaceous papules or small nodules. The periauricular area, face and scalp are mainly affected. Pruritis and bleeding may occur. Extracutaneous manifestation have been described on oral mucosa, parotid gland, orbit, colon and bones. Regional lymphadenopathy is presented in 5–10% of patients with angiolymphoid hyperplasia with eosinophilia. Peripheral blood eosinophilia is described in 10–20% of cases while the serum IgE level is usually within normal limits. Diagnosis of angiolymphoid hyperplasia with eosinophilia based on clinical findings and histopathological examination. Conventional therapies for the condition include corticosteroids (local and systemic), methotrexate, pentoxifylline, propranolol, isotretinoin, cryotherapy, thalidomide phototherapy, or surgical excision.