A Case of Eosinophilic Annular Erythema Treated Successfully with Colchicine
Bildiriler > Tam Metin Bildiri · 2023
Yazarlar: Ayris ÖZTÜRK, Banu YAMAN, Ayda ACAR
32nd Congress of the European Academy of Dermatology and Venereology, Almanya, Berlin, Uluslararası, Poster, Tam Metin Bildiri, 2023-2023, cilt -, ss ---
Özet
<p><strong>Introduction & Objectives:</strong></p><p>Eosinophilic annular erythema (EAE) is a rare eosinophilic dermatosis presented with recurrent urticarial and annular or polycyclic erythematous plaques with central healing. The disease usually appears on the trunk and proximal extremities, and is chronic and relapsing. Histologically, EAE is characterized by a superficial perivascular and interstitial mixed infiltrate with prominent eosinophils. To date, only a few cases of EAE have been reported in the literature. Herein, we report a case of EAE successfully treated with colchicine therapy.</p><p><strong>Materials & Methods:</strong></p><p>A 75-year-old woman presented to our clinic with itchy and painful erythematous plaques with a central clearing of 6 months duration on her extremities and torso. Dermatological examination revealed annular erythematous plaques with elevated borders, and central healing on her abdomen, back, upper, and lower extremities. She had no response to antihistamines, montelukast, topical corticosteroids, or emollients. She had a personal history of chronic lymphocytic leukemia (CLL) and hypertension.</p><p><strong>Results:</strong></p><p>Laboratory studies, including renal and liver function tests, total immunoglobulin E, anti-nuclear antibody, and complement levels, were normal. She had lymphocytosis and leukocytosis due to CLL. Malignancy screening showed no pathological results.</p><p>Histopathological examination revealed mild acanthosis, mild spongiosis, edema in the papillary dermis, and mixed perivascular interstitial inflammatory cell infiltration rich in eosinophil leukocytes. There were no signs of vasculitis, granuloma formation, flame figures, dermal mucin, or vacuolar changes (Figure 1).</p><p>Based on clinicopathological findings, the diagnosis of EAE was made. The patient was administered 1 milligram of colchicine, and the lesions completely cleared after one month, with no recurrence in two years of follow-up.</p><p><strong>Conclusion:</strong></p><p>EAE is a rare eosinophilic dermatosis with a differential diagnosis of Wells Syndrome, figurate erythemas, granuloma annulare, erythema multiforme, and urticarial phase of bullous pemphigoid. The pathogenesis of EAE remains unclear. Associated disorders consist of malignancies, chronic infections, and autoimmune diseases. Due to its potential association with malignancies, EAE patients can be candidates for cancer screening.</p><p>Effective and safe therapeutic options for EAE management are needed. Therapeutic options reported in the literature include topical corticosteroids, antimalarials, dapsone, thalidomide, and various biologic agents.</p><p>Colchicine is an alkaloid that inhibits tubulin polymerization, leading to subsequent downregulation of multiple inflammatory pathways and modulation of innate immunity. Because of its anti-inflammatory effect, colchicine’s inhibition of microtubule polymerization and altered expression of adhesion molecules and chemotactic factors could explain the adequate clinical response in our case.</p><p>In conclusion, we report a case of EAE successfully treated with colchicine without any relapse. The efficacy and safety of colchicine make this drug a new therapeutic option for this rare and difficult-to-treat disease. Further studies are necessary to confirm our findings.</p>