26- eosinophilic dermatoses

Question 1

What are the clinical features of granuloma faciale?

Answer 1

• solitary, asymptomtic smooth red-brown violaceous plaque on the face.
• prominent follicular openings

Question 2

What are the differential diagnosis of granuloma faciale?

Answer 2

• Lymphoma
• Pseudolymphoma
• Sarcoidosis
• Tumid lesions of lupus erythematosus
• polymourphous light eruption
• fixed drug eruption
• granulomatous diseases like leprosy, foreign body granulomas.

Question 3

What is the histology of granuloma faciale?

Answer 3

• epidermis normal
• lymphocytic infiltrate with numours eosinophils is characteristic.
• sparing of the upper papillary dermis creating a prominent Grenz zone.

Question 4

Histologically what are the differences between erythema elevatum diutinum?

Answer 4

• EED has no Grenz zone
• vasculitis more pronounced in EED
• neutrophils predominante over eosiniphils in EED.

Question 5

What is the treatment of granuloma faciale?

Answer 5

• intralseional corticosteroids
  anectodally:
• oral dapsone 50 -150 mg daily
• oral clofazimine 300 mg daily

Question 6

what are the clinical features of Well’s syndrome?

Answer 6

reccurent episodes ofprodromal itching/ burning and edematous nodules.

Blisters can occur.

Usually resolve over 4 to 6 weeks.

Question 7

What are the histological features of Well’s syndrome?

Answer 7

• diffuse infiltrate of eosiniphils with a mixture of lymphocytes and histocytes.
• most impressive in the deep dermis with occasional involvement of subcutaneous fat/fasica/mucle
• papillary dermal odemal
• flame figures.

Question 8

What are the clinical features of hypereosinophilia syndrome?

Answer 8

• peripheral blood eosiniphilia for at least 6 months
• signs and smptoms of multiorgan involvement
• no evidence of parasitic or allergic disease.