Case Number : Case 2375 - 31 July 2019 Posted By: Dr. Hafeez Diwan

Angiolymphoid hyperplasia with eosinophils

Agree!

I am impressed with epidermal changes with psudoepitheliomatous changes with foci of parakeratoticcolumn with inflammatory cells and somewhat like some trans epidermal elimination is happening. second point there is pan dermal inflammation with inflammatory cells close to the epidermis dermal junction

there is mixed inflammatory cells with histiocytes/lymphocytes and eosinophils and blood vessels

possibility

? tick bite granulomatous inflammation

are there remissions and recurrence-think of LyP

get Cd30 IHC it may be positive in both tick bite and LyP

Get CD1a too considering the young age

Angiolymphoid hyperplasia with eosinophilia.

I like insect bite too, forearm isn't the commonest site for ALHE, ulceration and wedge shaped doesn't fit as well; although those blood vessels with endothelial swelling, cross to my mind ALHE.

just for discussion endothelial cells could be also swollen in insect bite reaction

On 01/08/2019 at 05:50, Victor Delgado said:

I like insect bite too, forearm isn't the commonest site for ALHE, ulceration and wedge shaped doesn't fit as well; although those blood vessels with endothelial swelling, cross to my mind ALHE.

Agree completely