Facial edema and eosinophilia. Evidence for eosinophil degranulation

Two patients had recurrent facial edema and peripheral blood eosinophilia. One patient showed a marked increase in the serum level of the eosinophil granule major basic protein. In both patients, skin biopsy samples showed nonspecific mononuclear cell inflammation with few eosinophils. However, immunofluorescence staining showed extracellular localization of the major basic protein within the dermis, similar to that previously shown in chronic urticaria and the recently described syndrome of episodic angioedema with eosinophilia. These observations provide further evidence that degranulation of eosinophils occurs in the skin and suggest that eosinophil mediators may play a role in the development of cutaneous edema.