Angiolymphoid hyperplasia with eosinophilia in the eyelid: A case series and literature review.

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare vascular disorder characterized by the proliferation of blood vessels and lymphoid tissue. While it can occur in various regions of the body, ALHE presenting in the eyelid is relatively uncommon, leading to diagnostic and management challenges. In this case series from South India, we present three unique cases of ALHE specifically affecting the eyelids. Each case illustrates different clinical manifestations, diagnostic workups, and treatment approaches. Tissue biopsies typically reveal nodules comprising immature and mature vascular structures, including capillaries, arterioles, and venules, which are lined by plump endothelial cells with an epithelioid appearance. The surrounding stroma contains a dense infiltrate of inflammatory cells, predominantly eosinophils, histiocytes, lymphocytes, and mast cells. Increased awareness of ALHE in the eyelid will aid ophthalmologists in early recognition, accurate diagnosis, and appropriate management, resulting in improved patient outcomes.