Kimura's Disease - An Unusual Presentation

Kimura's disease is a rare chronic inflammatory disease of unknown etiology, presenting as painless subcutaneous nodules with lymphadenopathy and peripheral eosinophilia, mainly disturbing the head and neck region. It mainly affects Asian males in their 2(nd) to 4(th) decade of life. One such case of Kimura's disease, which is uncommon in Indian natives, is reported.

A male patient presented with an insidious onset of a progressive painless disfiguring swelling over his nose since four years, which was associated with nasal obstruction and post aural swelling with a history of an inconclusive incisional biopsy. Clinical examination showed a bilobed subcutaneous swelling present over the nose and a collapsed nasal valve area on anterior rhinoscopy. FNAC was non-diagnostic and CT scan showed a mildly enhancing mass lesion over the external nose. Complete surgical excision was performed. Diagnosis was confirmed upon postoperative histopathology. During his 2nd week follow up, the patient had a small nasal recurrence, which was treated medically with oral steroids, cetirizine, and pentoxyphylline for 4 weeks. The patient was disease free for 6 months.

Kimura's disease, although difficult to diagnosis clinically, should be considered in the differential diagnosis of patients who have a primary lymphadenopathy with eosinophilia with or without subcutaneous nodules. It should be investigated accordingly as the disease has an indolent course and good prognosis.