Eosinophilic dermatosis of hematologic malignancy
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
Differential Diagnosis & Pitfalls
- Arthropod bites – 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 EPF – Some authors believe that EDHM and malignancy-associated EPF are the same entity.
- Acute febrile neutrophilic dermatosis (Sweet syndrome)
- Dermal hypersensitivity reaction – Reaction to a medication, for example.
- Leukemia cutis
- Bullous pemphigoid
- Dermatitis herpetiformis
- Eosinophilic annular erythema
- Mycosis fungoides