Juvenile temporal arteritis. Biopsy study of four cases.

Two young adults (aged 21 and 22 years) and two children (aged 7 and 8 years) complained of an unsightly, soft, painless unilateral nodule in the temporal region, ranging from 0.5 to 1.5 cm in diameter, clinically diagnosed as lipoma, sebaceous cyst, or dermoid cyst. In each instance, the patient had no evidence of systemic disease or history of trauma, and the nodule was excised for cosmetic reasons. Histologic examination of the lesions showed non-giant-cell granulomatous inflammation of the temporal arteries with intimal proliferation and microaneurysmal disruption of the media. Whether the lesions represent a juvenile form of temporal arteritis, an unusual form of localized polyarteritis nodosa, or Kimura disease (subcutaneous angiolymphoid hyperplasia with eosinophilia) remains conjectural.