The punch biopsy specimen from the left helix showed a mixed inflammatory dermal infiltrate with lymphocytes and numerous eosinophils and proliferation of blood vessels with plump endothelial cells protruding into the lumen. The overlying epidermis was acanthotic.
The lesion was treated with an intralesional injection of 0.5 mL of 5-mg/mL triamcinolone acetonide suspension, with some improvement in the pruritus.
Angiolymphoid hyperplasia with eosinophilia presents with persistent and recurrent, solitary or multiple, pink to purple dome-shaped nodules that are usually located on the scalp, around the ears, and on the neck. Young to middle-age females are predominantly affected. Pruritus is the most common symptom. Spontaneous bleeding and pulsation over the lesion have been reported. The nodules are intradermal but can occasionally be subcutaneous. They usually measure less than 1 cm in diameter but may be as large as 10 cm. Peripheral eosinophilia and elevated levels of serum IgE occasionally occur.1
Persistent Pruritic Plaque of the Ear. Arch Dermatol. 1999;135(4):463-b-468. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-4-dof0499