Abstract

Follicular mucinosis is an epithelial reaction pattern characterized by mucinous deposition within the hair follicle. The literature suggests that mucin deposits result from the T cell mediated immune mechanism stimulating follicular keratinocytes. In follicular mucinosis, assessing the distinction between a benign and malignant process can be challenging. Angiolymphoid Hyperplasia and Eosinophilia, (“ALHE”) also known as epithelioid hemangioma (EH), is a benign inflamed vascular lesion which is characterized by the proliferation of histiocytoid endothelial cells in an eosinophil rich inflammatory background. The combination of follicular mucinosis with ALHE is extremely rare, having been reported in only 4 cases to date. In this study, we describe a 25-year-old patient with no other significant medical history who presented with multiple unilateral red nodules in the post auricular area. The histopathological examination of the tissue showed ALHE along with extensive follicular mucinosis. Atypia was not identified. Due to the rarity of this association, its diagnosis and treatment can pose a challenge for both dermatologists and dermatopathologists.

Financial Disclosure:
No current or relevant financial relationships exist.