Clinical and Diagnostic Insights into Penile Angiolymphoid Hyperplasia with Eosinophilia Based on a Case and Analysis of Previous Literature.

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare, benign vascular proliferation of unknown origin. It typically occurs in the head and neck region, but can occasionally manifest in unusual locations, such as the penis. Herein, we report a case of ALHE in a 46-year-old HIV-infected male presenting with multiple pruritic whitish nodules on the penile shaft with a size ranging from 0.5 × 0.5 × 0.1 cm to 1.1 × 0.6 × 0.2 cm, initially suspected to be nodular condyloma lata. However, negative serological syphilis test results excluded this initial diagnosis. Histopathological findings were consistent with ALHE, revealing plump endothelial cells and inflammatory infiltrates consisting of lymphocytes and eosinophils. The lesions did not fully resolve with topical corticosteroid therapy, thus necessitating surgical excision. As with ALHE at other sites, recurrence is to be anticipated. Although the pathogenesis remains unclear, an association between ALHE and HIV has been reported. ALHE presents both diagnostic and therapeutic challenges, particularly when it occurs in sensitive areas, such as the penis. While the penis is an atypical site for ALHE, awareness of this disease is important for dermatologists, and it should be included in the differential diagnosis of a penile nodule.