A case of angiolymphoid hyperplasia with eosinophilia (ALH) is reported in a 42-year-old woman who developed multiple nodules behind the ear. Angiolymphoid hyperplasia with eosinophilia usually occurs on the head and neck of young adults and is more common in women than in men. Characteristic histologic features of ALH present in this case included proliferation of thick-walled blood vessels lined by prominent endothelial cells, infiltration of the interstitium by chronic inflammatory cells (mainly eosinophils), and presence of lymphoid follicles with germinal centers. The patient referred for surgeon for complete excision. in this context , cases previously described in the literature, and the differential diagnosis of ALH are discussed.
Angiolymphoid hyperplasia with eosinophilia (ALH) is a rare benign vascular tumor characterized by solitary or multiple red to brown papules or nodules found mainly on the head and neck of young adults between 20 and 40 years of age,1 with a mean age at onset of 30 to 33 years.2 It has also been described in other tissues, including liver, orbit, spleen, palate, bone, heart, and blood vessels.1,3 It is more common in women than in men1 and is associated with peripheral blood eosinophilia of 6% to 34% in about 20% of patients.2,4 The lesions are often pruritic or painful and may coalesce into confluent plaques that are chronic, with little propensity for spontaneous resolution. Itching is significantly greater when the tumor is larger than 2 cm in diameter.1 A history of trauma is found in some patients (9% in the study by Olsen and Helwig4). The interval between trauma and the onset of the lesion ranges from 7 months to 20 years, with a median interval of 30 months.4 Lesion growth, tumor pulsation, and bleeding are other common presentations.2,4 Most intradermal lesions are small, with diameters of 0.5 to 2 cm; subcutaneous lesions may be much larger, up to 5 to 10 cm in diameter.2,5 The tumor is generally intradermal or subcutaneous, but it may involve deep soft tissues and vessels.1 Peripheral blood eosinophilia, enlargement of regional lymph nodes, and arteriovenous shunts have been reported but are variable features.4 We report a case of ALH that presentedas retroauricular nodules in 42-year-old woman.
APDBN Rashid, Review of International Geographical Education Online (RIGEO), 2021
The study aims to use the European Excellence Model (EFQM) in assessing the institutional performance of the National Center for Administrative Development and Information Technology in order to determine the gap between the actual reality of the performance of the Center and the standards adopted in the model, in order to know the extent to which the Center seeks to achieve excellence in performance to improve the level of services provided and the adoption of methods Modern and contemporary management in the evaluation of its institutional performance.
The problem of the study was the absence of an institutional performance evaluation system at the centre whereby weaknesses (areas of improvement) and st
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Type 2 diabetes is a global public health problem especially in middle east countries and Iraq has not spared from this pandemic. The prevalence in Iraq. and rank in Middle East. Beside increasing in prevalence- also poor glucose control. Nutrition plays a critical role. This paper narratively review variables that affect reduce the incidence of T2DM in Iraq and affect nutritional status among Iraqi withT2DM. The factors contribute to T2DM were high rates of obesity and overweight, as well as levels of body fat indicate a high prevalence of poor glycemic control. Likewise, levels of physical activity are low among older Iraqis.
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Throughout what mentioned above, It is obvious that the aware narrator in these biography models was the strongest tool in presenting the content, especially the biographies under study were written by feminine hands, striving to prove her identity by all means and ways. In addition, we can suppose that the hiding of she writer behind the character is no more than a mask, by which she want to mask herself so that she can express herself frankly and freely, especially when she talks about subjects that are inconsistent with the society, customs and traditions. It is important to refer that the existence of the participant narrator in the biographies under study does not prevent the presence of another narrator such as external or aware na
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