Eosinophils and associated parameters in different types of skin diseases related to elevated eosinophil levels

Eosinophils, basophils, white blood cells (WBC), and immunoglobulin E (IgE) play major roles in the pathogenesis of atopic dermatitis (AD), bullous pemphigoid (BP), drug reaction with eosinophilia and systemic symptoms (DRESS), and hypereosinophilic syndrome (HES). This study aimed to describe these parameters in different skin diseases and provide further information concerning the underlying pathogenesis.

A cross-sectional study of blood test results, including WBC count, peripheral eosinophil count, peripheral basophil/WBC percentage, and IgE level, from 115 cases of AD, 75 cases of BP, 55 cases of DRESS, 119 cases of HES, and 621 healthy volunteers was performed in China. Data from before and after treatment and the population distribution of different diseases were compared and described.

All participants showed increased peripheral eosinophil counts, eosinophil/WBC ratios, IgE levels, and decreased peripheral basophil counts, with variance among the different disease groups. Peripheral eosinophil counts in HES patients and IgE level in AD patients increased the most prominently. No significant correlation existed among eosinophils, basophils, and IgE. An obvious decrease in eosinophil count was demonstrated after treatment in all 4 diseases.

Eosinophils, basophils, and IgE exert functions in diverse skin diseases, presenting altered peripheral blood test results. In some cases, these changes are demonstrated only in the skin and not in the blood. Compared with the other parameters considered in this study, eosinophils seemed to be a better biomarker for treatment effects, regardless of the disease type.