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Eosinophilic Dermatosis of Hematologic Malignancy.

Gabriella Beharry¹, Rob Lawless¹, Muna Shakhashiro²

¹Dermatology, University of Kentucky College of Medicine, Lexington, USA.

|September 2, 2024

Summary

Eosinophilic dermatosis of hematologic malignancy (EDHM) is a rare skin condition often linked to chronic lymphocytic leukemia (CLL). This case details diagnostic challenges and treatment complexities for EDHM in patients with blood cancers.

Keywords:

dermatologic manifestations dermatological manifestation of malignancy eosinophilic dermatosis eosinophilic dermatosis of hematological malignancy hematologic malignancies medical dermatology

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Area of Science:

Dermatology
Hematology
Oncology

Background:

Eosinophilic dermatosis of hematologic malignancy (EDHM) is a rare, chronic skin condition.
It is frequently associated with underlying hematologic malignancies, particularly chronic lymphocytic leukemia (CLL).
EDHM typically manifests as intensely itchy, insect bite-like lesions without a history of insect contact.

Observation:

A 44-year-old male with a history of CLL presented with a scaly rash on his face.
The rash had characteristic serpiginous borders on the nasal tip and upper lip.
Initial treatments with antifungals and antibiotics were ineffective.

Findings:

A punch biopsy revealed perivascular and periadnexal lymphocytic dermatitis with eosinophils.
The patient's underlying CLL diagnosis, combined with biopsy findings, confirmed EDHM.
This case underscores the diagnostic difficulties in differentiating EDHM from other skin conditions.

Implications:

EDHM diagnosis requires a high index of suspicion in patients with hematologic malignancies.
Management of EDHM can be complex, necessitating a multidisciplinary approach.
This case emphasizes the importance of integrating dermatological and hematological assessments for rare conditions.