Eosinophilic annular erythema is a peculiar subtype in the spectrum of Wells syndrome: a multicentre long‐term follow‐up study
Identifieur interne : 000105 ( Istex/Corpus ); précédent : 000104; suivant : 000106Eosinophilic annular erythema is a peculiar subtype in the spectrum of Wells syndrome: a multicentre long‐term follow‐up study
Auteurs : M. El-Khalawany ; N. Al-Mutairi ; M. Sultan ; D. ShaabanSource :
- Journal of the European Academy of Dermatology and Venereology [ 0926-9959 ] ; 2013-08.
Abstract
Background/Objective Eosinophilic annular erythema (EAE) was proposed to describe annular skin lesions associated with tissue eosinophilia, however, its relation to Well’s syndrome (WS) remains a source of controversy. We studied a series of patients to increase awareness of this entity and to clarify its relation to WS. Methods A multicentre study in which the clinical records, histological findings, laboratory results, therapeutic responses and follow‐up of 10 patients were demonstrated. Results The study included seven women and three men with age ranging from 31 to 54 years. The duration of the disease ranged from 3 to 28 months. All patients showed involvement of trunk and extremities. Early lesions were manifested as erythematous plaques, which progressed to well‐developed figurate lesions and ended as large annular lesions with pigmented centre and elevated border. Flame figures were only observed in well‐developed and long‐standing lesions. Blood eosinophilia was found in all patients with different grades. Associated disorders included chronic gastritis, diabetes mellitus, chronic hepatitis‐C virus infection and chronic kidney disease. The disease showed chronic course with high relapse rate and resistance to various therapeutic modalities including systemic steroid alone and in combination with hydroxychloroquine and cyclosporine. Conclusion We believe that EAE is a peculiar clinical variant in the spectrum of WS, which is characterized by a chronic course, resistance to treatment and high relapse rate. The diagnosis and evaluation of this condition need a close monitoring with repeated clinical, histological and laboratory assessment.
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DOI: 10.1111/j.1468-3083.2012.04616.x
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Sultan</name><affiliation><mods:affiliation>Department of Dermatology, Faculty of Medicine, Al‐Azhar University, Cairo, Egypt</mods:affiliation></affiliation></author><author><name sortKey="Shaaban, D" sort="Shaaban, D" uniqKey="Shaaban D" first="D." last="Shaaban">D. 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El-Khalawany</name><affiliation><mods:affiliation>Department of Dermatology, Faculty of Medicine, Al‐Azhar University, Cairo, Egypt</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: makhalawany@gmail.com</mods:affiliation></affiliation></author><author><name sortKey="Al Utairi, N" sort="Al Utairi, N" uniqKey="Al Utairi N" first="N." last="Al-Mutairi">N. Al-Mutairi</name><affiliation><mods:affiliation>Department of Dermatology, Faculty of Medicine, Kuwait University, Kuwait</mods:affiliation></affiliation></author><author><name sortKey="Sultan, M" sort="Sultan, M" uniqKey="Sultan M" first="M." last="Sultan">M. Sultan</name><affiliation><mods:affiliation>Department of Dermatology, Faculty of Medicine, Al‐Azhar University, Cairo, Egypt</mods:affiliation></affiliation></author><author><name sortKey="Shaaban, D" sort="Shaaban, D" uniqKey="Shaaban D" first="D." last="Shaaban">D. Shaaban</name><affiliation><mods:affiliation>Department of Dermatology, Faculty of Medicine, Tanta University, Gharbiya, Egypt</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Journal of the European Academy of Dermatology and Venereology</title><title level="j" type="alt">JOURNAL OF EUROPEAN ACADEMY DERMATOLOGY VENEREOLOGY</title><idno type="ISSN">0926-9959</idno><idno type="eISSN">1468-3083</idno><imprint><biblScope unit="vol">27</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="973">973</biblScope><biblScope unit="page" to="979">979</biblScope><biblScope unit="page-count">7</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2013-08">2013-08</date></imprint><idno type="ISSN">0926-9959</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0926-9959</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background/Objective Eosinophilic annular erythema (EAE) was proposed to describe annular skin lesions associated with tissue eosinophilia, however, its relation to Well’s syndrome (WS) remains a source of controversy. We studied a series of patients to increase awareness of this entity and to clarify its relation to WS. Methods A multicentre study in which the clinical records, histological findings, laboratory results, therapeutic responses and follow‐up of 10 patients were demonstrated. Results The study included seven women and three men with age ranging from 31 to 54 years. The duration of the disease ranged from 3 to 28 months. All patients showed involvement of trunk and extremities. Early lesions were manifested as erythematous plaques, which progressed to well‐developed figurate lesions and ended as large annular lesions with pigmented centre and elevated border. Flame figures were only observed in well‐developed and long‐standing lesions. Blood eosinophilia was found in all patients with different grades. Associated disorders included chronic gastritis, diabetes mellitus, chronic hepatitis‐C virus infection and chronic kidney disease. The disease showed chronic course with high relapse rate and resistance to various therapeutic modalities including systemic steroid alone and in combination with hydroxychloroquine and cyclosporine. Conclusion We believe that EAE is a peculiar clinical variant in the spectrum of WS, which is characterized by a chronic course, resistance to treatment and high relapse rate. 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Shaaban</name><affiliations><json:string>Department of Dermatology, Faculty of Medicine, Tanta University, Gharbiya, Egypt</json:string></affiliations></json:item></author><articleId><json:string>JDV4616</json:string></articleId><arkIstex>ark:/67375/WNG-Z27NMJPQ-D</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Background/Objective Eosinophilic annular erythema (EAE) was proposed to describe annular skin lesions associated with tissue eosinophilia, however, its relation to Well’s syndrome (WS) remains a source of controversy. We studied a series of patients to increase awareness of this entity and to clarify its relation to WS. Methods A multicentre study in which the clinical records, histological findings, laboratory results, therapeutic responses and follow‐up of 10 patients were demonstrated. Results The study included seven women and three men with age ranging from 31 to 54 years. The duration of the disease ranged from 3 to 28 months. All patients showed involvement of trunk and extremities. Early lesions were manifested as erythematous plaques, which progressed to well‐developed figurate lesions and ended as large annular lesions with pigmented centre and elevated border. Flame figures were only observed in well‐developed and long‐standing lesions. Blood eosinophilia was found in all patients with different grades. Associated disorders included chronic gastritis, diabetes mellitus, chronic hepatitis‐C virus infection and chronic kidney disease. The disease showed chronic course with high relapse rate and resistance to various therapeutic modalities including systemic steroid alone and in combination with hydroxychloroquine and cyclosporine. Conclusion We believe that EAE is a peculiar clinical variant in the spectrum of WS, which is characterized by a chronic course, resistance to treatment and high relapse rate. 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El-Khalawany et al.</json:string><json:string>Karabudak et al.</json:string><json:string>Rongioletti et al.</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/WNG-Z27NMJPQ-D</json:string></ark><categories><wos><json:string>1 - science</json:string><json:string>2 - dermatology</json:string></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - clinical medicine</json:string><json:string>3 - dermatology & venereal diseases</json:string></scienceMetrix><scopus><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Infectious Diseases</json:string><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Dermatology</json:string></scopus><inist><json:string>1 - sciences appliquees, technologies et medecines</json:string><json:string>2 - sciences biologiques et medicales</json:string><json:string>3 - sciences medicales</json:string></inist></categories><publicationDate>2013</publicationDate><copyrightDate>2013</copyrightDate><doi><json:string>10.1111/j.1468-3083.2012.04616.x</json:string></doi><id>FC2C10547BDD89266A1268AD891CB1973634461A</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-Z27NMJPQ-D/fulltext.pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-Z27NMJPQ-D/bundle.zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/ark:/67375/WNG-Z27NMJPQ-D/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main">Eosinophilic annular erythema is a peculiar subtype in the spectrum of Wells syndrome: a multicentre long‐term follow‐up study</title><title level="a" type="short">Eosinophilic annular erythema is a peculiar subtype in the spectrum of Wells syndrome</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><availability><licence>© 2012 The Authors. 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<ref target="http://www.tei-c.org/">We use TEI</ref></desc></application></appInfo></encodingDesc><profileDesc><abstract xml:lang="en" style="main"><head>Abstract</head><p><hi rend="bold">Background/Objective </hi> Eosinophilic annular erythema (EAE) was proposed to describe annular skin lesions associated with tissue eosinophilia, however, its relation to Well’s syndrome (WS) remains a source of controversy. We studied a series of patients to increase awareness of this entity and to clarify its relation to WS.</p><p><hi rend="bold">Methods </hi> A multicentre study in which the clinical records, histological findings, laboratory results, therapeutic responses and follow‐up of 10 patients were demonstrated.</p><p><hi rend="bold">Results </hi> The study included seven women and three men with age ranging from 31 to 54 years. The duration of the disease ranged from 3 to 28 months. All patients showed involvement of trunk and extremities. Early lesions were manifested as erythematous plaques, which progressed to well‐developed figurate lesions and ended as large annular lesions with pigmented centre and elevated border. Flame figures were only observed in well‐developed and long‐standing lesions. Blood eosinophilia was found in all patients with different grades. Associated disorders included chronic gastritis, diabetes mellitus, chronic hepatitis‐C virus infection and chronic kidney disease. The disease showed chronic course with high relapse rate and resistance to various therapeutic modalities including systemic steroid alone and in combination with hydroxychloroquine and cyclosporine.</p><p><hi rend="bold">Conclusion </hi> We believe that EAE is a peculiar clinical variant in the spectrum of WS, which is characterized by a chronic course, resistance to treatment and high relapse rate. The diagnosis and evaluation of this condition need a close monitoring with repeated clinical, histological and laboratory assessment.</p></abstract><textClass><keywords rend="tocHeading1"><term>ORIGINAL ARTICLES</term></keywords><keywords rend="articleCategory"><term>ORIGINAL ARTICLE</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc><revisionDesc><change when="2019-12-20" who="#istex" xml:id="pub2tei">formatting</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-Z27NMJPQ-D/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1468-3083</doi><issn type="print">0926-9959</issn><issn type="electronic">1468-3083</issn><idGroup><id type="product" value="JDV"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="JOURNAL OF EUROPEAN ACADEMY DERMATOLOGY VENEREOLOGY">Journal of the European Academy of Dermatology and Venereology</title></titleGroup></publicationMeta><publicationMeta level="part" position="08108"><doi origin="wiley">10.1111/jdv.2013.27.issue-8</doi><numberingGroup><numbering type="journalVolume" number="27">27</numbering><numbering type="journalIssue" number="8">8</numbering></numberingGroup><coverDate startDate="2013-08">August 2013</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="5" status="forIssue"><doi origin="wiley">10.1111/j.1468-3083.2012.04616.x</doi><idGroup><id type="unit" value="JDV4616"></id></idGroup><countGroup><count type="pageTotal" number="7"></count></countGroup><titleGroup><title type="tocHeading1">ORIGINAL ARTICLES</title><title type="articleCategory">ORIGINAL ARTICLE</title></titleGroup><copyright>© 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology</copyright><eventGroup><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:3.2.2 mode:FullText" date="2013-07-09"></event><event agent="SPS" date="2013-07-09" type="xmlCorrected"></event><event type="publishedOnlineEarlyUnpaginated" date="2012-06-25"></event><event type="firstOnline" date="2012-06-25"></event><event type="publishedOnlineFinalForm" date="2013-07-17"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:4.0.1" date="2014-03-19"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.6.4 mode:FullText" date="2015-10-03"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="973">973</numbering><numbering type="pageLast" number="979">979</numbering></numberingGroup><correspondenceTo> M. El‐Khalawany. <b>E‐mail:</b><email>makhalawany@gmail.com</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:JDV.JDV4616.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Received: 2 April 2012; Accepted: 21 May 2012</unparsedEditorialHistory><countGroup><count type="figureTotal" number="5"></count><count type="tableTotal" number="1"></count></countGroup><titleGroup><title type="main">Eosinophilic annular erythema is a peculiar subtype in the spectrum of Wells syndrome: a multicentre long‐term follow‐up study</title><title type="shortAuthors">M. El‐Khalawany <i>et al.</i></title><title type="short">Eosinophilic annular erythema is a peculiar subtype in the spectrum of Wells syndrome</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1" corresponding="yes"><personName><givenNames>M.</givenNames><familyName>El‐Khalawany</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a2"><personName><givenNames>N.</givenNames><familyName>Al‐Mutairi</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1"><personName><givenNames>M.</givenNames><familyName>Sultan</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a3"><personName><givenNames>D.</givenNames><familyName>Shaaban</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="EG"><unparsedAffiliation>Department of Dermatology, Faculty of Medicine, Al‐Azhar University, Cairo, Egypt</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="KW"><unparsedAffiliation>Department of Dermatology, Faculty of Medicine, Kuwait University, Kuwait</unparsedAffiliation></affiliation><affiliation xml:id="a3" countryCode="EG"><unparsedAffiliation>Department of Dermatology, Faculty of Medicine, Tanta University, Gharbiya, Egypt</unparsedAffiliation></affiliation></affiliationGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p><b>Background/Objective </b> Eosinophilic annular erythema (EAE) was proposed to describe annular skin lesions associated with tissue eosinophilia, however, its relation to Well’s syndrome (WS) remains a source of controversy. We studied a series of patients to increase awareness of this entity and to clarify its relation to WS.</p><p><b>Methods </b> A multicentre study in which the clinical records, histological findings, laboratory results, therapeutic responses and follow‐up of 10 patients were demonstrated.</p><p><b>Results </b> The study included seven women and three men with age ranging from 31 to 54 years. The duration of the disease ranged from 3 to 28 months. All patients showed involvement of trunk and extremities. Early lesions were manifested as erythematous plaques, which progressed to well‐developed figurate lesions and ended as large annular lesions with pigmented centre and elevated border. Flame figures were only observed in well‐developed and long‐standing lesions. Blood eosinophilia was found in all patients with different grades. Associated disorders included chronic gastritis, diabetes mellitus, chronic hepatitis‐C virus infection and chronic kidney disease. The disease showed chronic course with high relapse rate and resistance to various therapeutic modalities including systemic steroid alone and in combination with hydroxychloroquine and cyclosporine.</p><p><b>Conclusion </b> We believe that EAE is a peculiar clinical variant in the spectrum of WS, which is characterized by a chronic course, resistance to treatment and high relapse rate. The diagnosis and evaluation of this condition need a close monitoring with repeated clinical, histological and laboratory assessment.</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p><b>Conflicts of interest</b>
None declared.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Eosinophilic annular erythema is a peculiar subtype in the spectrum of Wells syndrome: a multicentre long‐term follow‐up study</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Eosinophilic annular erythema is a peculiar subtype in the spectrum of Wells syndrome</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Eosinophilic annular erythema is a peculiar subtype in the spectrum of Wells syndrome: a multicentre long‐term follow‐up study</title></titleInfo><name type="personal"><namePart type="given">M.</namePart><namePart type="family">El‐Khalawany</namePart><affiliation>Department of Dermatology, Faculty of Medicine, Al‐Azhar University, Cairo, Egypt</affiliation><affiliation>E-mail: makhalawany@gmail.com</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">N.</namePart><namePart type="family">Al‐Mutairi</namePart><affiliation>Department of Dermatology, Faculty of Medicine, Kuwait University, Kuwait</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M.</namePart><namePart type="family">Sultan</namePart><affiliation>Department of Dermatology, Faculty of Medicine, Al‐Azhar University, Cairo, Egypt</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">D.</namePart><namePart type="family">Shaaban</namePart><affiliation>Department of Dermatology, Faculty of Medicine, Tanta University, Gharbiya, Egypt</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2013-08</dateIssued><edition>Received: 2 April 2012; Accepted: 21 May 2012</edition><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><extent unit="figures">5</extent><extent unit="tables">1</extent></physicalDescription><abstract lang="en">Background/Objective Eosinophilic annular erythema (EAE) was proposed to describe annular skin lesions associated with tissue eosinophilia, however, its relation to Well’s syndrome (WS) remains a source of controversy. We studied a series of patients to increase awareness of this entity and to clarify its relation to WS. Methods A multicentre study in which the clinical records, histological findings, laboratory results, therapeutic responses and follow‐up of 10 patients were demonstrated. Results The study included seven women and three men with age ranging from 31 to 54 years. The duration of the disease ranged from 3 to 28 months. All patients showed involvement of trunk and extremities. Early lesions were manifested as erythematous plaques, which progressed to well‐developed figurate lesions and ended as large annular lesions with pigmented centre and elevated border. Flame figures were only observed in well‐developed and long‐standing lesions. Blood eosinophilia was found in all patients with different grades. Associated disorders included chronic gastritis, diabetes mellitus, chronic hepatitis‐C virus infection and chronic kidney disease. The disease showed chronic course with high relapse rate and resistance to various therapeutic modalities including systemic steroid alone and in combination with hydroxychloroquine and cyclosporine. Conclusion We believe that EAE is a peculiar clinical variant in the spectrum of WS, which is characterized by a chronic course, resistance to treatment and high relapse rate. The diagnosis and evaluation of this condition need a close monitoring with repeated clinical, histological and laboratory assessment.</abstract><relatedItem type="host"><titleInfo><title>Journal of the European Academy of Dermatology and Venereology</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><subject><genre>article-category</genre><topic>ORIGINAL ARTICLES</topic><topic>ORIGINAL ARTICLE</topic></subject><identifier type="ISSN">0926-9959</identifier><identifier type="eISSN">1468-3083</identifier><identifier type="DOI">10.1111/(ISSN)1468-3083</identifier><identifier type="PublisherID">JDV</identifier><part><date>2013</date><detail type="volume"><caption>vol.</caption><number>27</number></detail><detail type="issue"><caption>no.</caption><number>8</number></detail><extent unit="pages"><start>973</start><end>979</end><total>7</total></extent></part></relatedItem><relatedItem type="references" displayLabel="cit1"><titleInfo><title>Tissue eosinophilia as an indicator of drug‐induced cutaneous small‐vessel vasculitis</title></titleInfo><name type="personal"><namePart type="given">S</namePart><namePart type="family">Bahrami</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">JC</namePart><namePart type="family">Malone</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">KG</namePart><namePart type="family">Webb</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">JP</namePart><namePart type="family">Callen</namePart><role><roleTerm type="text">author</roleTerm></role></name><genre>journal-article</genre><note type="citation/reference">Bahrami S, Malone JC, Webb KG, Callen JP. 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