Red Alert or Red Herring?

McCalmont, Timothy H.

doi:10.1111/cup.12324

Cited by 7 publications

(8 citation statements)

References 17 publications

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“…Tissue eosinophilia has also been reported in secondary syphilis, but it is felt to be rare . Elevated levels of eosinophil chemoattractants have been documented in patients with syphilis.…”

Section: Discussionmentioning

confidence: 99%

“…Drug reactions and allergic contact dermatitis are often the primary consideration in eosinophil‐rich skin lesions biopsied in the United States. A recent editorial highlighted the potential diagnostic pitfall of limiting our diagnoses in eosinophil‐rich lesions, as a wide spectrum of diseases, including lichen planus and melanocytic tumors, can have increased eosinophils . In one study on the pathologic features of alopecia areata, nearly half of the cases had eosinophils within fibrous tracts .…”

mentioning

confidence: 99%

“…A recent editorial highlighted the potential diagnostic pitfall of limiting our diagnoses in eosinophil-rich lesions, as a wide spectrum of diseases, including lichen planus and melanocytic tumors, can have increased eosinophils. 7 In one study on the pathologic features of alopecia areata, nearly half of the cases had eosinophils within fibrous tracts. 8 Although syphilis is rare, affecting 5.3 per 100,000 in 2013, the incidence of syphilis in the United States nearly doubled from 2005 to 2013, with high rates of human immunodeficiency virus (HIV) co-infection.…”

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confidence: 99%

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Eosinophil‐rich syphilis: a report of four cases

2015

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The differential diagnosis for eosinophil-rich skin lesions often includes a drug reaction, allergic contact dermatitis and rarely, response to a helminth infection. However, many unrelated entities, such as infections, neoplasms and inflammatory dermatoses, can have a prominent eosinophilic infiltrate. Syphilis is classically associated with plasma cells, but other patterns of inflammation have been reported, including ulcerative, granulomatous and eosinophil-rich. Classic teaching might indicate that the presence of eosinophils argues against a diagnosis of syphilis. We present four cases of secondary syphilis with increased eosinophils, ranging from 8 to >200 eosinophils per 10 high-power fields (×400 magnification). Patient 1 had lesions on the penis and scrotum, with greater than 200 eosinophils per 10 high-power fields. Patient 2 had lesions on the back, with 150 eosinophils per 10 high-power fields. Patient 3 had lesions on the bilateral arms, with 8 eosinophils per 10 high-power fields. Patient 4 had lesions involving the anus, with 17 eosinophils per 10 high-power fields. These cases highlight that the presence of an eosinophil-rich infiltrate on skin biopsy should not exclude syphilis from the differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Eosinophil‐rich syphilis: a report of four cases

2015

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Section: Discussionmentioning

confidence: 99%

“…Eosinophils are commonly thought be indicative of certain conditions such as allergic contact dermatitis or lichenoid drug eruption, and to be absent or rare in others such as idiopathic LP or graft-vs.-host disease. 11 LS is also one of these conditions in which eosinophils are thought to be rare. 2 However, similar to the recent findings of Alomari and McNiff 12 and others, 13 in which increased eosinophils were found in idiopathic LP (in particular the hypertrophic variety) unrelated to a drug etiology, and Marra et al 14…”

Section: Discussionmentioning

confidence: 99%