Eosinophilic Annular Erythema as a Subset of Wells Syndrome or a Distinct Entity: Report of Two Cases

Abstract

Eosinophilic annular erythema (EAE) is an uncommon acute eosinophilic dermatosis of unknown etiology. Urticarial papules and plaques as pruritic lesions appear in annular and arcuate forms on the trunk and proximal limbs and rarely affect the face. In histopathological diagnosis, EAE has typical features, including acute dermal inflammatory infiltrate with abundant eosinophils and lymphocytes around arteries. In spite of no clear treatment, the findings indicated the positive effects of systemic corticosteroid, hydroxychloroquine, and Ultraviolet B therapy along with recurrences. Two patients have been elected in the present study. The first patient was a middle-aged diabetic female with urticarial papules and plaques around the pelvis and proximal thighs that had active borders with improved centers. We started with 400 mg of hydroxychloroquine and 25 mg of prednisone for the patient whose lesions were subsided during the first week. The second consulted patient was a 41-year-old female without a history of previous illness with four months of painful, pruritic, and violaceous plaques on the back of the trunk. In histopathology, dermal inflammatory infiltrate with abundant eosinophils was observed in the dermis. Corticosteroids and hydroxychloroquine were prescribed with the diagnosis of EAE for this patient as well.

Keywords: Wells syndrome, Eosinophilic annular erythema, Case report