Eosinophilic annular erythema: successful response to ultraviolet B therapy

Abstract

Eosinophilic annular erythema (EAE) is a rare and relatively newly described eosinophil-rich dermatosis. Debate still exists as to whether it represent a subtype of Well syndrome or a separate disease entity. We report an 8-year-old boy with a 4-year history of recurrent, asymptomatic annular lesions, which were diagnosed after clincopathological correlation as EAE. This condition usually runs a relapsing and remitting course with resistance to multiple treatments. Prednisolone and hydroxychloroquine have been reported as successful but the response to these was limited in this case. Complete resolution occurred after treatment with ultraviolet B (UVB) therapy. To our knowledge, this is the first report of a favourable response of EAE to such therapy.

Atypical presentation of eosinophilic annular erythema in a 5‐year‐old girl

“…7,8 There are single reports describing good response to prednisolone, indomethacin, dapsone and ultraviolet B (UVB) therapy. 2,9,10 In our patient, the disease resolved spontaneously, and 12 months later, a sustained remission was evident.…”

Eosinophilic annular erythema: A late but complete response to hydroxychloroquine

“…The aetiopathogenesis of EAE remains obscure, although it has been suggested that it occurs as a result of a hypersensitivity reaction to an unidentified antigen . The disease has been associated with hyperthyroiditis, borreliosis, chronic gastritis with Helicobacter pylori infection, diabetes mellitus, chronic hepatitis C virus infection, chronic kidney disease, clear cell renal carcinoma, thymoma and metastatic prostate adenocarcinoma . Our patient had autoimmune hypothyroidism, which has not been reported previously in association with EAE.…”

“…EAE is a recently described chronic and recurrent figurate erythematous dermatosis of unknown aetiology. There are limited numbers of case reports of this condition in the literature . It is still debated whether EAE is a distinct entity or an annular variant of Wells' syndrome, also called eosinophilic cellulitis.…”

“…Currently, there is no standard treatment for EAE. Previous cases have responded to antimalarials, systemic corticosteroids, dapsone, indomethacin, or UVB therapy . Spontaneous resolution is also possible after weeks to years .…”

Dapsone treatment for eosinophilic anular erythema

“…The EAE management is still a therapeutic challenge. 1,3,[6][7][8] Recently reported excellent response to dapsone in one EAE patient, 6 as well as the report of dapsone…”