KIMURAS-DISEASE

A 40-year-old white Caucasian man presented with a 6-month history of a 1.5 x 1.5 cm nodular lesion on his left arm. No history of trauma pr eceeded the lesion acid the patient was in good general health. Dermat ologic examination revealed a solitary, red, painless nodule located o n the left arm (Fig. 1). Histopathologic examination of punch biopsy r evealed lymphoid follicles, some of which had active germinal centers in the deep dermis acid subcutaneous tissue. Mixed infiltration of lym phocytes, plasma cells and many eosinophils were present in the interf ollicular region, infiltration of the germinal centers by eosinophils, causing partial destruction, was observed (Fig. 2A), There was also p roliferation of thin-walled small vessels and fibrosis in some parts o f the interfollicular areas (Fig. 2B). Although Kimura's disease (KD) and angiolymphoid hyperplasia with eosinophilia (ALHE) were considered in the differential diagnosis, it was diagnosed as KD based on these histologic features. Further laboratory examinations were performed. S erum IgE was normal and peripheral eosinophilia was absent. The lesion regressed after biopsy. Complete healing was achieved with intralesio nal corticosteroid (triamcinolone acetonide) treatment.