BackgroundThe pathogenesis of eosinophilic dermatosis of hematologic malignancy (EDHM) is poorly understood. Previously thought to be a hypersensitivity reaction to insect bites, immune dysregulation and cytokine imbalance are now thought to be responsible. Its prognostic significance is unclear. ObjectiveTo describe the clinical, pathological and immunological findings in a series of oncohematological patients with EDHM. MethodsAn observational prospective cohort study of oncohematological patients receiving a diagnosis of EDHM between April 2017 and December 2018. ResultsA total of 15 patients with EDHM (10 females and 5 males) were identified among 422 oncohematological patients. Disease presentation varied from firm erythematous papules to more polymorphic presentations. The lesions were most prevalent on the exposed sites, 8/15 patients recalled an insect bite. Lesion seasonality was reported in 13/15 patients. IgE levels were elevated in six patients, circulating IL-4 and IL-5 were within a normal range. Twelve out of 15 patients developed skin manifestations after chemotherapy. The infiltrate could be eosinophil-rich or lymphocytic-rich. Interestingly, the histopathologic findings were in accordance with arthropod bites. ConclusionA role for insect bites in EDHM is supported by our findings. EDHM may be related to aggressive hematologic disease.

Eosinophilic dermatosis of hematologic malignancy in patients with chronic lymphocytic leukemia/non-Hodgkin's B lymphoma: a single center prospective clinico-pathological study

Michelerio, Andrea
;
Tomasini, Carlo;Fiandrino, Giacomo;Varettoni, Marzia;Defrancesco, Irene;Cavalloni, Chiara;Brazzelli, Valeria;Derlino, Federica;Paulli, Marco;Arcaini, Luca;
2023-01-01

Abstract

BackgroundThe pathogenesis of eosinophilic dermatosis of hematologic malignancy (EDHM) is poorly understood. Previously thought to be a hypersensitivity reaction to insect bites, immune dysregulation and cytokine imbalance are now thought to be responsible. Its prognostic significance is unclear. ObjectiveTo describe the clinical, pathological and immunological findings in a series of oncohematological patients with EDHM. MethodsAn observational prospective cohort study of oncohematological patients receiving a diagnosis of EDHM between April 2017 and December 2018. ResultsA total of 15 patients with EDHM (10 females and 5 males) were identified among 422 oncohematological patients. Disease presentation varied from firm erythematous papules to more polymorphic presentations. The lesions were most prevalent on the exposed sites, 8/15 patients recalled an insect bite. Lesion seasonality was reported in 13/15 patients. IgE levels were elevated in six patients, circulating IL-4 and IL-5 were within a normal range. Twelve out of 15 patients developed skin manifestations after chemotherapy. The infiltrate could be eosinophil-rich or lymphocytic-rich. Interestingly, the histopathologic findings were in accordance with arthropod bites. ConclusionA role for insect bites in EDHM is supported by our findings. EDHM may be related to aggressive hematologic disease.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11571/1487122
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