Eosinophilic annular erythema in adults: report of two cases and review of the literature

Abstract

We herein report two cases of eosinophilic annular erythema in adults, which is rare. In both patients, lesions developed rapidly in few days and were located mainly on the trunk, buttocks, and extremities. Diagnosis was histopathological, with typical features including acute dermal inflammatory infiltrate with abundant eosinophils. One of the patients recurred after treatment on three occasions and finally cured spontaneously. The second patient recurred once and was then successfully treated with topical clobetasol. Clinical and histopathological features of eosinophilic annular erythema in adults have rarely been reported. A review of the literature and discussion of relationship with Wells syndrome are also included.

Figure 1

An annular lesion on one side of the thorax with erythematous-edematous margins, and a minimally scaly center

Figure 2

A: Hyperplasia of the epidermis. Perivascular and interstitial (arrow) mixed infiltrate with abundant eosinophils. Absence of flame figures and vasculitis (Hematoxylin & eosin, X10). B: A cluster of eosinophils (circle), more abundant around the central vessel (Hematoxylin & eosin, X40)

Figure 3

Minimally scaly, annular, erythematous plaques on the buttocks and trunk

Figure 4

A: Superficial and deep dermatitis, perivascular and extending to the interstitium with presence of lymphocytes and plasma cells, as well as eosinophils. (Hematoxylin & eosin, X8). B: Presence of eosinophils (arrow) in the interstitium and inside a blood vessel (Hematoxylin & eosin, X40)