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Eosinophilic dermatosis of hematologic malignancy
Other Resources UpToDate PubMed

Eosinophilic dermatosis of hematologic malignancy

Contributors: Layal Antoury, Susan Burgin MD
Other Resources UpToDate PubMed


Eosinophilic dermatosis of hematologic malignancy (EDHM), also known as insect bite-like persistent hypersensitivity reaction, is a rare eosinophilic eruption associated with hematoproliferative diseases. Clinical presentations vary, ranging from erythematous or urticarial papules, plaques, or nodules, to vesicles and bullae. Lesions have a tendency to persist over long periods and recur, and they may be accompanied by significant pruritus.

Although clinical and histological features simulate insect bites, the condition is currently regarded as a paraneoplastic cutaneous reaction pattern likely mediated by interleukin (IL)-4 and IL-5.

EDHM is most commonly associated with chronic lymphocytic leukemia, affecting up to 7% of patients in some studies. It has also been reported in patients with myelofibrosis, acute myelomonocytic leukemia, acute lymphocytic leukemia, mantle cell lymphoma, large cell lymphoma, and myeloma. EDHM can precede, occur concurrently, or appear after the cancer diagnosis. EDHM is a disease of adults. The youngest reported patient with EDHM was 21 years of age.


L99 – Other disorders of skin and subcutaneous tissue in diseases classified elsewhere

95320005 – Disorder of skin

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Arthropod bite or sting – Consider recent outdoor exposure, distribution of lesions on exposed sites, and seasonal variations. Some patients may have recollection of antecedent insect bites.
  • Papular urticaria
  • Eosinophilic cellulitis (Wells syndrome)
  • Immunosuppression-associated Ofuji disease – Some authors believe that EDHM and malignancy-associated EPF are the same entity.
  • Acute febrile neutrophilic dermatosis (Sweet syndrome)
  • Drug-induced hypersensitivity syndrome – Reaction to a medication, for example.
  • Leukemia cutis
  • Bullous pemphigoid
  • Dermatitis herpetiformis
  • Eosinophilic annular erythema
  • Cutaneous T-cell lymphoma

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Last Reviewed:08/24/2020
Last Updated:08/24/2020
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Eosinophilic dermatosis of hematologic malignancy
A medical illustration showing key findings of Eosinophilic dermatosis of hematologic malignancy : Erythematous
Copyright © 2024 VisualDx®. All rights reserved.