Eosinophilic Dermatosis of Hematologic Malignancy

Abstract

Dermatosis characterized by tissue eosinophilia arising in the context of hematologic disease is known as eosinophilic dermatosis of hematologic malignancy. The most commonly associated malignancy is chronic lymphocytic leukemia. Eosinophilic dermatosis of hematologic malignancy is a rare condition with a wide variety of clinical presentations, ranging from papules, erythematous nodules, or blisters that simulate arthropod bites, to the formation of true plaques of differing sizes. Histology reveals the presence of abundant eosinophils. We present 4 new cases seen in Hospital Arnau de Vilanova, Valencia, during the past 7 years. Three of these cases were associated with chronic lymphocytic leukemia and 1 with mycosis fungoides. It is important to recognize this dermatosis as it can indicate progression of the underlying disease, as was the case in 3 of our patients.

Lenalidomide in the management of eosinophilic dermatosis of hematological malignancy

“…The clinical findings are pruritic, frequently tender papules, nodules and vesicles/bullae resembling insect bites occurring on both sun‐exposed and non‐exposed areas of the body. A linear pattern of the lesions can be observed in some cases like described by Lucas‐Truyols et al ., and even mimic a varicella zoster infection like in the patient of Cohen et al . In our patient, the lesions were localized on the back following Langer's lines, in a distribution known as Christmas tree pattern.…”

“…Many different treatments have been proposed, most of them associated with partial response and recurrence. Skin‐directed therapies including topical corticosteroids and phototherapy are usually not effective, with complete response in a small number of the cases . The use of oral corticosteroid in doses of 0.5–1 mg/kg per day leads to a good initial response, although relapses are common with dose reduction .…”

“…They can be classified into two major groups: specific (cutaneous involvement by leukemic cells), affecting 8.3% of patients; and paraneoplastic or non‐specific (not leukemic), affecting up to 45% of patients . Among dermatoses in the latter group, eosinophilic dermatosis of hematological malignancy (EDHM) is described in patients with chronic lymphocytic leukemia (CLL), B‐cell lymphomas, acute monocytic leukemia, myelofibrosis and mycosis fungoides . It is a condition with a wide variety of clinical presentations, ranging from papules, erythematous nodules and blisters that simulate arthropod bites, to the formation of true plaques of differing sizes .…”

“…2,3 It is a condition with a wide variety of clinical presentations, ranging from papules, erythematous nodules and blisters that simulate arthropod bites, to the formation of true plaques of differing sizes. 3 Histology reveals lymphocytic infiltrate in the superficial and deep dermis rich in eosinophils. 4 Many different treatments have been proposed, but partial response and recurrence are frequent.…”

“…Improvement has been seen with chemotherapy and corticosteroids, but no therapeutic option is generally accepted. 3,5 Herein, we describe a case of eosinophilic dermatosis associated with mantle cell lymphoma with remission after lenalidomide therapy.…”