Multiple Grouped Scalp Nodules in a Middle-Aged Man: A Rare Case of Angiolymphoid Hyperplasia with Eosinophilia.

An otherwise healthy man in his 50s presented complaining of pruritic lesions on the left side of his scalp. The lesions had slowly been growing in size over the preceding 30 years. They would occasionally bleed, and this is what ultimately prompted him to seek medical advice. Physical examination revealed multiple aggregated and soft, flesh-colored nodules on the left posterior auricular area of the scalp (Figure 1). No appreciable clinical lymphadenopathy was identified on examination. A shave biopsy of one of the nodules was performed for diagnostic clarification.

Hiperplasia angiolinfoide con eosinofilia: a propósito de dos casos / Angiolymphoid hyperplasia with eosinophilia: a propos of two cases

La Hiperplasia Angiolinfoide con Eosinofilia (HALE) es una proliferación vascular benigna, poco frecuente, que se caracteriza por nódulos localizados preferentemente en el cuero cabelludo, región periauricular y cuello, en adultos jóvenes. La histopatología muestra proliferación de vasos sanguíneos con endotelio prominente, acompañada de un infiltrado inflamatorio que incluye eosinófilos y linficitos. El tratamientos de elección es la resección quirúrgica; sin embargo, las recurrencias son frecuentes. Se presentan dos casos clínicos, se revisa la literatura y se discute la relación entre HALE y enfermedad de Kimura.

[Kimura's disease on the hard palate in a patient from Martinique]. / Maladie de Kimura à localisation palatine chez un Antillais.

INTRODUCTION: We report an observation of Kimura's disease (angiolymphoid hyperplasia with eosinophilia) in a Black patient from West Indies, in a rare localisation on hard palate. EXEGESIS: A 46-year-old male patient from French West Indies (Martinique) presented with a tumor of hard palate evolving from 2 years with locoregional lymph nodes. He had a history of chronic urticaria, prurigo, rhinitis and alopecia areata. Pathological examination of the tumor was consistent with the diagnosis of Kimura's disease. Blood tests showed hypereosinophilia, elevation of IgG and IgE. The serology of Toxocara canis with Western blott was positive. Corticosteroid therapy (0.7 mg/kg/d) and albendazole (800 mg/d) allowed regression of the tumor, lymph nodes, and urticaria. The remaining tumor was surgically excised. CONCLUSION: Kimura's disease was first described in Japanese young men, between 20 and 40 years old, with subcutaneous nodules on head and neck area. Involvement of oral mucosa is rare, and the occurence in West Indian patients has been rarely reported.