Eosinophilia and skin Grunderkrankung + D72.1

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 10.04.2022

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Synonym(s)

Dermatoses eosinophils; Eosinophilic dermatoses; Eosinophilic skin diseases; Hypereosinophilic dermatoses; Skin diseases eosinophils

Definition
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Skin manifestations characterized by eosinophilic infiltrates of the skin (accompanying insect bites, drug reactions, atopic dermatitits or other neoplastic or immmunological misreactions) and/or by hematoeosinophilia.

Eosinophilia is the elevation of the normal value of eosinophilic granulocytes in blood (normal value: 2-4% or 50-500/µl) or tissues. Hematoeosinophilia is present when the absolute number of eosinophils of 500/µl is exceeded (> 50% of total leukocytes).

The formerly used term "hypereosinophilia" (> 1500/µl) is no longer in use and is only used nomenclatorically in the so-called hypereosinophilia syndrome.

Classification
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  • Primary eosinophilia:
    • clonal eosinophilia
    • idiopathic eosinophilia.
  • Secondary eosinophilia:
    • reactive eosinophilia.
  • Primary eosinophilias include clonal and idiopathic forms. Clonal eosinophilias are predominantly hematologic neoplasms or myelodysplastic and -proliferative disorders.
  • Reactive (or secondary) eosinophilias include all conditions in which a short-term or persistent eosinophilia always occurs in association with a detectable disease (e.g., parasitic disease, malignant tumors) or cause (e.g., drugs) of nonclonal origin. Numerous other dermatologic diseases are also classified here.

The following is a list of diseases that are constantly or inconstantly accompanied by blood eosinophilia:

Occurrence/Epidemiology
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The most common cause in Europe is allergies (> 20% of the population); increasingly, drugs are used as a cause of eosinophilia. Worldwide, parasitoses are the leading cause: depending on the region, up to 80% of the population can be affected.

Diagnosis
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Procedure for eosinophilia:
  • Medical history (allergies, atopy, family history, medication, vaccinations, travel history)
  • Physical examination (which organs are involved, skin, heart, lungs, GIT)
  • Laboratory: blood count, ECP, stool tests (parasites), prick, RAST

Notice! A eosinophile count > 1500/ul is rather unusual for allergic diseases. The constellation of haematoeosinophilia and non-specific skin symptoms requires haematological clarification.

Note(s)
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A rearrangement of the genes of the "platelet-derived growth-factor receptor" (PDGFR) alpha and beta can be detected in various clonal hemato-eosinophilia. By inhibition of certain cytoplasmic tyrosinases ( imatinib) influenced by this receptor, primary eosinophilia can be successfully treated.

Literature
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  1. Wozel G (2007) Eosinophilia dermatoses. dermatologist 58: 347-360

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 10.04.2022