Oral Angiolymphoid Hyperplasia With Eosinophilia Exhibiting Cutaneous-Type Histopathologic Features: Clinical Regression Following Hormonal Withdrawal and a 50-Year Review.

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare benign vascular proliferation, typically affecting the head and neck's subcutaneous tissue, with infrequent involvement of the oral mucosa. We report the case of a 30-year-old female patient on oral contraceptives who presented with a hyperplastic, reddish-purple, asymptomatic, and bleeding gingival lesion in the left maxillary gingiva. Clinical examination revealed a 10 mm periodontal pocket in the upper left permanent canine, with horizontal bone loss affecting the adjacent lateral incisor and canine. Blood analysis showed mild eosinophilia. An initial incisional biopsy suggested a chronic inflammatory process, but due to persistent lesion growth, histopathological revaluation confirmed ALHE. Management included contraceptive discontinuation, scaling and root planing, and intralesional corticosteroid therapy, resulting in complete remission within 14 days. This case highlights the importance of considering ALHE in the differential diagnosis of hyperplastic gingival lesions with periodontal involvement. Furthermore, conservative treatment may offer an effective alternative to surgical excision for intraoral ALHE. A review of cases of oral ALHE in the last 50 years is also provided.