Eosinophilic Dermatosis of Hematologic Malignancy D72.1

Chronic recurrent eosinophilic dermatosis in hematologic neoplasia is a rare (just over 200 patients have been described to date - Cohen PR 2020), multiform, "paraneoplastic" disorder whose common denominator is histo- and blood eosinophilia in underlying leukemic lymphoid neoplasia (Almeida FT et al 2020).

Figures on incidence are not yet known; m:w=1.3:1.0

The pathogenesis of the disease has not yet been elucidated. However, it is likely that neoplastic B cells, directly or indirectly (by stimulating a reactive polyclonal T cell response), play an etiologic role. Furthermore, the recruitment of eosinophils to the skin may be secondary to a shift in the immune system toward a T helper 2 response, possibly caused by the neoplastic cells, leading these T cells to produce interleukin-4 (Cohen PR 2020).

Clinically, itchy erythematous plaques, often arranged in a zoster-like pattern, are present; disseminated nodules and blisters reminiscent of insect bites or occurring after previous insect bites may also be detectable.

Most commonly, these changes are associated with chronic lymphocytic leukemia (CLL) (in a larger compilation of 208 patients, 160 were diagnosed with CLL - Cohen PR 2020). Less commonly, there is an association with mycosis fungoides (Lucas-Truyols S et al 2017).

Therapeutically, dupilumab is recommended (Jin A et al 2019).

1. Almeida FT et al (2020) Eosinophilic dermatosis of hematologic malignancy: a case report. Dermatol Online J 26:13030/qt4k8908jb.

2. Bari O et al. (2017) Eosinophilic dermatosis of hematologic malignancy mimicking varicella zoster infection: report in a woman with chronic lymphocytic leukemia and review of the literature. Dermatol Pract Concept 7:6-15.

3. Cohen PR (2020) What's in a name? a new nomenclature has been proposed For eosinophilic dermatosis of hematologic malignancy (EDHM): hematologic-related malignancy-induced eosinophilic dermatosis (He Remained). Dermatol Online J 26: 13030/qt1zd6p6z2.
4. Jin A et al. (2019) Eosinophilic dermatosis of hematologic malignancy responding to dupilumab in a patient with chronic lymphocytic leukemia. JAAD Case Rep 5:815-817.
5. Lucas-Truyols S et al (2017) Eosinophilic dermatosis of hematologic malignancy. Actas Dermosifiliogr 108:e39-e44.