[Eosinophilic arteritis of the scalp]

The occurrence of recurrent peripheral arterial thromboses together with a blood eosinophilia generally suggests an occlusive vascular disease or a systemic vasculitis.

In a 31-year-old woman with a 15-year history of severe smoking and a blood eosinophilia from 1,200 to 2,500/mm(3), we observed recurrent attacks of pruritus and urticaria and recurrent lesions of eosinophilic thromboangiitis of hypodermal medium-sized elastic arteries of the scalp. In spite of the persistent eosinophilia, the evolution was spontaneously regressive and no other clinical or biological sign occurred within a follow-up time of 3 years.

In Buerger's disease (thromboangiitis obliterans) and in most systemic vasculitis, especially in Churg-Strauss syndrome, the first lesions may be inflammatory thromboses of the extra-cranial scalp arteries. The diagnosis of an eosinophilic arteritis of the scalp may only be considered if the examination of the other peripheral vessels is normal and if the course of the disease is benign, without any treatment, in spite of a persistent blood eosinophilia. This clinico-pathological presentation should be considered as a distinct entity.