Angiolymphoid hyperplasia with eosinophilia developing on an antecedent welding burn: a case report

Angiolymphoid hyperplasia with eosinophilia (ALHE) describes a group of benign anomalous vascular hyperplasias which consist of epithelioid-like endothelial cells attached to dilated blood vessels, and infiltration of inflammatory cells, predominantly lymphocytes and some eosinophils. Here, we describe a healthy 34-year-old man, who had 10 well-defined, non-tender, red-to-brownish papules and subcutaneous nodules of 0.3-1.0 cm in diameter on his left forearm. The lesions started to appear about 4 months after an earlier electric welding rod burn had healed. The histopathologic diagnosis of the lesions was ALHE. Because the new lesions developed progressively and malignancy could not be excluded, the patient underwent a wide elliptical excision and received a split-thickness skin graft from his left thigh. His postoperative recovery was successful and has showed no evidence of recurrence after 5 years of follow-up. The forearm is an unusual site for ALHE; the antecedent burn was the key trigger for ALHE onset in this case.