“…9,13,14,15 Because eosinophils themselves are a prominent source of many of these mediators, CHES can best be thought of as a disease of unrestrained self-perpetuating inflammation and that once eosinophils are recruited, they provide the growth factors necessary for their further recruitment, proliferation, activation, and survival. 13,14,16,17 This certainly is consistent with the chronicity of this disorder and the requirements for frequent surgical revisions. As such, although allergy might be important in precipitating or possibly exacerbating the disorder, it has to be recognized that ongoing allergen exposure may not be required for its persistence.…”