Characteristics of dermatological patients with blood eosinophilia: a retrospective analysis of 453 patients.

Radonjic-Hoesli, Susanne; Martignoni, Zora; Cazzaniga, Simone; Furrer, Dominique Isabel; Simon, Hans-Uwe; Bürgler, Christina; Simon, Dagmar (2022). Characteristics of dermatological patients with blood eosinophilia: a retrospective analysis of 453 patients. The journal of allergy and clinical immunology. In practice, 10(5), 1229-1237.e8. Elsevier 10.1016/j.jaip.2022.02.018

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BACKGROUND

Skin diseases associated with blood or tissue eosinophilia are common. As their clinical manifestations are various, making the correct diagnosis can be challenging. So far, dermatological patients with concomitant blood eosinophilia have not been characterized.

OBJECTIVE

We aimed at investigating patterns of dermatological patients with concomitant blood eosinophilia in order to obtain information helpful for optimizing disease management.

METHODS

In this retrospective study, demographic and clinical data and diagnostic test results of all patients presenting with dermatoses associated with blood eosinophilia (DABE) referred to a university center from 2014 to 2018 were extracted from the electronic patient charts and evaluated using descriptive and semantic map analyses.

RESULTS

A total of 453 patients (51.4% females; mean age 58.4 ±21.7 years) were included and grouped according to blood absolute eosinophil counts: severe, ≥1.5 G/L (n=87; 19.2%), moderate, 1.0 - 1.49 G/L (n=73; 16.1%), and mild eosinophilia, 0.5 - 0.99 G/L (n=293; 64.7%). Most patients presented with chronic (64.6%), generalized skin lesions (75.9%), and pruritus (88.1%). Statistical analyses revealed three distinct patterns: 1. mild eosinophilia associated with localized skin disease, age <50 years, history of atopy, diagnosis of eczema or infectious disease, 2. moderate eosinophilia linked to generalized skin lesions, pruritus, age > 70 years, and autoimmune bullous disease, and 3. severe eosinophilia associated with diagnosis of hypereosinophilic syndromes, drug hypersensitivity or malignant disesase.

CONCLUSIONS

Based on the pattern analysis of patients with DABE, a diagnostic workup has been developed aiming at setting the correct differential diagnosis in a feasible and effective manner.

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