Neutrophilic and eosinophilic dermatoses associated with hematological malignancy

Abstract

Cutaneous manifestations of hematologic malignancy represent both a clinical challenge for the treating physician and a pathophysiological model for advancing the knowledge on individual neoplasms. Indeed, a growing body of evidence supports the concept of recurrent molecular defects associating with specific clinical features, as best exemplified by VEXAS. Herein neutrophilic and eosinophilic dermatoses of potential interest for both hematologists and dermatologists will be reviewed, including subcorneal pustular dermatosis-type IgA pemphigus, neutrophilic eccrine hidradenitis, Sweet’s syndrome as well as myelodysplasia cutis and VEXAS, pyoderma gangrenosum, eosinophilic annular erythema, eosinophilic dermatosis of hematological malignancy, Wells syndrome and cutaneous involvement in hypereosinophilic syndromes. Possible management approaches are discussed for each, emphasizing scenarios that require treatment of the underlying condition to achieve remission at the skin level.

Exploring the Potential of IL-4 and IL-13 Plasma Levels as Biomarkers in Atopic Dermatitis

“…Unfortunately, despite our efforts, we were unable to identify a consistent pattern in the data. Moreover, increased levels of type 2 cytokines have been identified not only in AD but also in other conditions like eosinophilic dermatosis of hematological malignancy [ 46 ]. Further investigation could aim to assess the potential reduction in these cytokine levels using Dupilumab treatment in this uncommon condition, opening up avenues for valuable research.…”

Ophthalmic vascular manifestations in eosinophil-associated diseases: a comprehensive analysis of 57 patients from the CEREO and EESG networks and a literature review

“…In daily practice, cardiovascular manifestations related to the toxicity of eosinophils mainly consist of eosinophilic myocarditis, endomyocardial fibrosis, endocardial thrombi (with potential systemic emboli) ( 10 ), venous thromboembolism ( 11 ), and eosinophilic vasculitis in patients with idiopathic HES ( 12 , 13 ) Eosinophilia can also be associated with organ and/or life-threatening manifestations e.g. , thromboangiitis obliterans-like disease ( 14 , 15 ), coronary vasospasm ( 16 ) or ischemic strokes of border zone distribution ( 17 ), all of which can have poor outcomes ( 18 ).…”

“…Visual prognosis was poor: only eight (10%) patients achieved full recovery of ophthalmologic symptoms. After a median follow-up of 10.5 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] months, one patient (3%) had a recurrence of an ophthalmic vascular manifestation, and three patients (10%) had a recurrence of other vascular symptoms (deep vein thrombosis in two and pulmonary embolism in one patient). At the time of recurrence, absolute eosinophil counts were above 0.5 x10 9 /L in all cases (n=4).…”

“…more than three months of follow-up), the median follow-up after the initial ophthalmic vascular manifestation was 10.5[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] months. One (3%) patient had a recurrence of ophthalmic vascular manifestation (CRVO) and three (10%) patients had another vascular event (lower limb deep vein thrombosis n=2, pulmonary embolism n=1).…”

Comparative immunohistochemical analysis of inflammatory cytokines in distinct subtypes of Sweet syndrome

“…Sweet syndrome (SS) is characterized by a neutrophil-rich inflammatory infiltration into the skin in the absence of an infection ( 1 ). It is frequently associated with systemic diseases — especially hematologic malignancy — inflammatory bowel disease, and immune-mediated rheumatologic disorders ( 1 , 2 ). Until now, the pathogenic mechanism of SS remains unclear; however, the available evidence suggests that the dysregulated expression of cytokines and growth factors have been implicated in the pathogenesis ( 1 , 3 ).…”