Ann Dermatol.  2009 Feb;21(1):71-74. 10.5021/ad.2009.21.1.71.

Angiolymphoid Hyperplasia with Eosinophilia That Was Possibly Induced by Vaccination in a Child

• Jeon EK
• Cho AY
• Kim MY
• Lee Y
• Seo YJ
• Park JK
• Lee JH

• KMID: 2172072
• DOI: http://doi.org/10.5021/ad.2009.21.1.71

Abstract

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare benign vasoproliferative disease of an unknown cause involving the skin or subcutaneous tissue of the head and neck, and particularly around the ear. It predominantly affects Caucasian adults during the third and fourth decades and it very rarely occurs in children. We experienced a case of ALHE in a 2-year-old Korean boy who had a firm, pruritic, skin-colored, subcutaneous nodule on his right upper arm. The histopathological findings were compatible with ALHE and they showed prominent vascular changes with epitheloid or histiocytoid endothelial cells surrounded by inflammatory cells, including a large proportion of eosinophils. This unusual distribution of the lesion and the young age of the patient may be associated with vaccination.

Keyword

Angiolymphoid hyperplasia with eosinophilia; Child; Vaccination

MeSH Terms

Adult
Angiolymphoid Hyperplasia with Eosinophilia
Arm
Child
Ear
Endothelial Cells
Eosinophils
Head
Humans
Neck
Preschool Child
Skin
Subcutaneous Tissue
Vaccination

Figure

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  Fig. 1 A solitary, firm, skin-colored nodule on the right upper arm.

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  Fig. 2 (A) Several lymphoid aggregates without germinal centers showing lymphocyte and eosinophil infiltration (H&E, ×40). (B) Vascular proliferation with "epitheloid" or "histiocytoid" endothelial cells. There is a cobblestone appearance of enlarged endothelial cells that project into the vessel lumen and a perivascular cellular infiltration that mainly consists of eosinophils and lymphocytes in the dermis (H&E, ×100).

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  Fig. 3 Positive staining for factor VIII-related antigen (immunoperoxidase, ×100) on the walls of the proliferating vessels.

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  Fig. 4 (A) The diffuse, nodular T cell infiltration immunostained for CD3 (immunoperoxidase, ×100) and (B) the small B cell clusters and diffuse infiltration seen with CD20 staining (immunoperoxidase, ×100).

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