Intra-arterial angiolymphoid hyperplasia with eosinophilia mimicking temporal arteritis: A case report and review of the literature

Abstract

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare benign disease of unknown etiology, characterized by abnormal vascular proliferation. ALHE usually presents with painful, itchy, or asymptomatic lesions in the neck region, particularly around the ears. Clinically, it is usually around the ear, at the border of the scalp. It can be seen as single or multiple nodules or papules lesions on the neck and neck. Medium-sized peripheral muscular artery involvement is rare. A 41-year-old male patient, presented to a rheumatology clinic for 1 year history of a soft painless swelling in his bilateral temporal region. He sustained no preceding trauma to the area and had no additional symptoms. On physical examination, temporal arteries were prominent, but there was no tenderness. The patient had no clinical signs of temporal arteritis. Temporal artery Doppler ultrasound was performed, which revealed an echogenic asymmetric vessel wall thickening in the bilateral superficial temporal arteries. Temporal artery biopsy yielded the final diagnosis of ALHE, a rare vascular involvement of unknown etiology. ALHE is a condition that should be kept in mind in the differential diagnosis of temporal arteritis.