Angiolymphoid Hyperplasia with Eosinophilia Located on the Forehead: A Possible Association with Oral Contraceptive Use?

Abstract

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon benign vasoproliferative tumor characterized by nodules, papules or plaques localized principally in the head and neck region. Histopathological examination reveals hyperplastic blood vessels lined by large endothelial cells, accompanied by an infiltrate of inflammatory cells including eosinophils. The pathogenetic mechanism remains unclear, although different theories have been proposed. Various treatment strategies have been described, but surgery remains the treatment of choice. We describe the case of a young woman with ALHE taking an oral contraceptive pill suggesting a possible etiopathogenetic relationship.

Angiolymphoid hyperplasia with eosinophilia along with arteriovenous malformation: an unusual case

“…1,4 The etiopathogenesis of angiolymphoid hyperplasia with eosinophilia remains obscure till date. 5 In our patient, the growth of multiple satellite skin lesions, histologically confirmed as angiolymphoid hyperplasia with eosinophilia on the left-posterior aspect of scalp, along with concomitant arteriovenous malformations on the lower scalp, suggests a causal relationship between them. The feeding arteries of this arteriovenous malformation served as the backdrop for developing secondary vascular abnormalities in the reticular dermis and subsequent cutaneous lesions.…”

“…Although surgical excision remains the first-line treatment for angiolymphoid hyperplasia with eosinophilia, 5 multiple therapeutic modalities have been tried including corticosteroids, pentoxifylline, interferon alfa-2a, imiquimod, tacrolimus, thalidomide, oral isotretinoin, acitretin, cytotoxic agents and other options such as radiotherapy, photodynamic therapy, cryotherapy, electrodesiccation and laser therapy. 5 In conclusion, we suggest meticulous physical examination along with imaging techniques such as B-mode ultrasonography, colour Doppler and angiography if multifocal angiolymphoid hyperplasia with eosinophilia is suspected, especially involving the scalp. Appropriate therapy should be instituted after diagnostic confirming.…”