Angiolymphoid Hyperplasia With Eosinophilia: New Concept to Lower Recurrence

Area of Science:

• Dermatology
• Surgical Oncology
• Pathology

Background:

• Angiolymphoid Hyperplasia with Eosinophilia (AHLE) is a rare vascular disorder with unknown etiology.
• Despite WHO classification as benign, AHLE exhibits locally aggressive behavior and high recurrence rates.
• Common treatment modalities include steroids, intralesional injections, and surgical excision, yet recurrence remains a significant issue.

Observation:

• A case of recurrent AHLE in the left concha and preauricular region of a middle-aged female is presented.
• The lesion was excised with a 4mm safety margin, preserving auricular cartilage.
• The resulting defect was reconstructed using a grafted Temporoparietal Fascia Flap.

Findings:

• A 1-year follow-up demonstrated an aesthetically acceptable outcome with no recurrence of AHLE.
• The proposed surgical approach, treating AHLE as a locally malignant tumor with wide margins, appears effective in reducing recurrence.
• Reconstruction with a temporoparietal fascia flap provided satisfactory aesthetic results and minimal donor site morbidity.

Implications:

• This approach may offer a more effective strategy for managing recurrent AHLE, potentially improving patient outcomes.
• Treating AHLE with wide surgical margins could be a paradigm shift in its management.
• Temporoparietal fascia flap reconstruction is a viable option for defect coverage, balancing oncologic and aesthetic principles in AHLE management.