Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
J Eur Acad Dermatol Venereol. 2017 Nov;31(11):1916-1923. doi: 10.1111/jdv.14350. Epub 2017 Jun 21.
Eosinophilic annular erythema (EAE) has been proposed as a clinical entity to describe annular skin lesions associated with tissue eosinophilia. However, systematic investigations on the histopathology of EAE have not been performed, and useful histopathological findings for diagnosis of EAE remain unknown.
The aim of this study was to investigate the clinicopathological features of EAE.
We retrospectively studied 10 patients at our hospital during a 5-year span who clinically showed annular or figurate lesions and histopathologically exhibited eosinophilic infiltration in the dermis.
Nine of the 10 cases had annular lesions with pigmentation on the interior side. Blood eosinophilia was found in only one patient. Histopathologically, basal melanosis was observed in nine cases. Infiltration of eosinophils was confined to the dermis in nine cases. Patients treated with systemic corticosteroid tended to show less recurrence than those treated with topical corticosteroid.
The main limitation of our study is the small number of patients.
Skin biopsy should be performed when EAE is suspected, even in cases without blood eosinophilia. Basal melanosis and tissue eosinophilia confined to the dermis suggest the diagnosis of EAE. We recommend topical corticosteroids as the initial treatment for EAE.
嗜酸性环形红斑(EAE)被提议作为一种临床实体,用于描述与组织嗜酸性粒细胞增多相关的环形皮肤病变。然而,尚未对 EAE 的组织病理学进行系统研究,也不知道用于诊断 EAE 的有用组织病理学发现。
本研究旨在探讨 EAE 的临床病理特征。
我们对我院在 5 年内的 10 例临床表现为环形或图形皮损且组织病理学显示真皮嗜酸性粒细胞浸润的患者进行了回顾性研究。
9 例中有 9 例为内侧有色素沉着的环形病变。仅 1 例患者有血液嗜酸性粒细胞增多。组织病理学观察到 9 例基底黑色素沉着。9 例患者的嗜酸性粒细胞浸润局限于真皮。接受全身皮质类固醇治疗的患者比接受局部皮质类固醇治疗的患者复发率低。
本研究的主要局限性是患者数量较少。
当怀疑 EAE 时,即使在没有血液嗜酸性粒细胞增多的情况下,也应进行皮肤活检。基底黑色素沉着和局限于真皮的组织嗜酸性粒细胞提示 EAE 的诊断。我们建议局部皮质类固醇作为 EAE 的初始治疗方法。