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Vol. 110. Issue 7.
Pages 590-596 (September 2019)
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Vol. 110. Issue 7.
Pages 590-596 (September 2019)
BRIEF COMUNICATIONS
DOI: 10.1016/j.adengl.2018.07.017
Clinical, Dermoscopic and Histologic Features of Recurrent Cutaneous Eosinophilic Vasculitis Cases
Características clínicas, dermatoscópicas e histológicas de varios casos de vasculitis eosinofílica recurrente cutánea
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E.G. Quijano-Gomeroa, M.J.M. Rodríguez-Zúñigaa,b,
, M.E. Sanz-Monteroc, D. Durand-Busea
a Unidad de Dermatología, Hospital Nacional Daniel Alcides Carrión, Callao, Perú
b Universidad Nacional Mayor de San Marcos, Lima, Perú
c Instituto de Patología Arias Stella, Lima, Perú
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Table 1. Recurrent Cutaneous Eosinophilic Vasculitis cases.
Table 2. Descriptive analysis of the seventeen cases included in the review.
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Abstract

Primary recurrent cutaneous eosinophilic vasculitis is a rare condition characterized by pruritic, erythematous, purpuric plaques associated to edema. We compared and analyze the clinical, dermoscopic and histological features of the disease in 4 patients from our hospital and 13 patients published in the literature. Seventeen patients were included, with a median age of 56yo, a median duration of disease of 6 months. Lesions were most frequently generalized (47%) or localized in lower limbs (41%). The most frequent features were purpuric color (71%), local edema (65%), necrotizing vasculitis (94%) and eosinophil infiltration (100%) in histology. Most of the patients (82.4%) were given oral steroids with a median dose of 30mg. Primary recurrent cutaneous eosinophilic vasculitis might be an infra-diagnosed condition. The analysis of the patients allowed us to propose diagnostic criteria for the definition of this disease. We suggest a therapeutic strategy with high-potency steroids and dapsone, which might be considered as first-line treatment.

Keywords:
Vasculitis
Eosinophils
Leukocytoclasia
Fibrinoid necrosis
Corticosteroids
Dapsone
Resumen

La vasculitis eosinofílica recurrente cutánea primaria es una enfermedad rara, caracterizada por placas purpúricas, eritematosas y pruriginosas asociadas a edema. Comparamos y analizamos las características clínicas, dermatoscópicas e histológicas de la enfermedad en 4 pacientes de nuestro hospital y en 13 casos de pacientes publicados previamente. Se incluyeron 17 pacientes, con una mediana de edad de 56 años, y una mediana de duración de la enfermedad de 6 meses. En la mayoría de los casos las lesiones fueron generalizadas (47%) o localizadas en los miembros inferiores (41%). Las características histológicas más frecuentes fueron: color purpúrico (71%), edema local (65%), vasculitis necrosante (94%) e infiltración eosinofílica (100%). La mayoría de los pacientes (82,4%) recibió esteroides orales (mediana de la dosis de 30mg). La vasculitis eosinofílica recurrente cutánea primaria podría ser una entidad clínica infradiagnosticada. El análisis de los pacientes nos permitió proponer algunos criterios diagnósticos para su definición. Recomendamos una estrategia terapéutica con esteroides de alta potencia y dapsona, pudiéndose considerar como el tratamiento de primera línea.

Palabras clave:
Vasculitis
Eosinófilos
Leucocitoclasia
Necrosis fibrinoide
Corticosteroides
Dapsona

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