INFLAMMATORY ANGIOMATOUS NODULES WITH ABNORMAL BLOOD VESSELS OCCURRING ABOUT THE EARS AND SCALP (PSEUDO OR ATYPICAL PYOGENIC GRANULOMA)

Abstract

SUMMARY.— Persistent angiomatous nodules and plaques about the ears and scalp with distinctive histological features are described. Of the 12 women and 2 men affected, 9 showed involvement of the external auditory meatus, the pinna or the retroauricular fold. Three patients presented with lesions in the occipital region and solitary nodules affecting the nasolabial fold and forehead occurred in 2 patients. Eight patients had multiple lesions with bleeding and pruritus as the main symptoms. Several recurred after removal. The characteristic histological features were the presence of abnormal hypertrophied capillaries with greatly swollen endothelial cells and an associated lympho-histiocytic and eosinophil infiltrate. The abnormal endothelial cells showed absent or greatly diminished alkaline phosphatase activity, but enhanced reactions were obtained to certain hydrolytic and oxidative enzymes as compared to normal capillary endothelium. Pseudopyogenic granuloma appears to be an entirely benign reactive condition. Its relationship to ordinary pyogenic granuloma and to subcutaneous angiolymphoid hyperplasia with eosinophilia is discussed.