Digital necrosis in a patient with hypereosinophilic syndrome in the absence of cutaneous eosinophilic vasculitis

Extensive Digital Gangrene Without Evidence of Large-vessel Occlusion in Hypereosinophilic Syndrome

“…True TAO, characterized by painful ulcers on the acral areas should be differentiated. Vascular abnormalities revealed on the imaging studies may not be a useful clue in differentiating TAO from TAO-like occlusion in HES (3,5,9). Typical pain occurring in patients with TAO may be a differential point, as necrosis in HES can be painless, as in our patient.…”

“…pruritic papules, eczema-like patches, urticarial plaques, and angioedema ( 1). In HES patients, occlusions of intermediate-to largesized arteries frequently cause peripheral ischaemia and even digital gangrene (2)(3)(4)(5)(6). Digital necrosis without evidence for vascular occlusion has rarely been described in patients with HES (7).…”

Hypereosinophilic syndrome with various skin lesions and juvenile temporal arteritis

“… 5 reported a 34‐year‐old patient with HES who presented with cutaneous necrotizing eosinophilic vasculitis and Raynaud’s phenomenon complicated by digital gangrene. There have been other published reports on HES accompanied by digital gangrene and Raynaud’s phenomenon in the English‐language literature 6,7 . Histopathological findings show necrotizing vasculitis of the small vessels with a prominent infiltrate of eosinophils 5 .…”

“…Oppliger et al. 7 described digital necrosis in HES associated with the occlusion of medium‐sized arteries but without cutaneous vasculitis.…”

Superficial Venous Thrombophlebitis as the Initial Manifestation of Hypereosinophilic Syndrome

“…[14][15][16][17][18] Peripheral arterial involvement occurs occasionally in HES. 15,16,19 Although deep venous thrombosis has been reported, to our knowledge SVT has not been previously reported in HES.…”