Esoinophilic cellulitis is a rare dermatosis originally described by Wells as "reccurent granulomatous dermatitis with eosinophilia", then called Well's syndrome. The etiology is unknown, although a hypersensitivity meechanism is suspected. Flame
figures are considered as a characteristic histologic feature of Wells' syndrome.
To clarify the nature of eosinophilic cellulitis and its flame figures, the author has reviewed five cases of eosinophilic cellulitis with its clinical and histopathologic findings Cutaneous lesions were variable in appearance and was commonly
confused
with angioedema, urticarial vasculitis, erythema multiforme, morphea or granuloma annulare.
Microscopically, early lesions (2-7days) showed diffuse dermal eosinophilic infiltration with widespread degranulation, sometimes extended into the underlying muscle. Subepidermal bulla was present in one cases. Subsequently, granulomatous
features
with
characteristic "flame figures" became apparent (several months). Collagen alteration by eosinophilic granules resulted in flame figure formation and a granulomatous response. In two patients, there were possible relationships between drug and
flare-ups
of eosinophilic cellulitis, but the others, no contributary precipitating factors were found.
We think that eosinophilic celluitis represents a severe anaphylactic hypersensitivity reaction to various stimuli showing characteristic histopathology with recurrent episodes and frequent hypereosinophilia in the peripheral blood.
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