Abstract:

Introduction: Eosinophilic annular erythema (EAE) presents as a figurate erythema and has only recently been noted in the medical literature. The etiology causing EAE is still unclear, but the literature indicates associations with several chronic conditions and malignancies. Herein, we report the case of a 66-year woman presenting with an itchy rash. Methods: We report a case of a 66-year-old woman with no significant clinical history presenting with an itchy rash on the bilateral palms, wrists and feet for a 6 month duration. Physical examination revealed non-tender pink-blanchable papules on the bilateral hands and fingers in an arcuate pattern. A CBC identified eosinophils on the high end of normal. A punch biopsy revealed a superficial inflammatory infiltrate within the dermis. The perivascular and interstitial infiltrate was composed of abundant eosinophils and lymphocytes. Eosinophils were also infiltrating the vessel walls. Flame figures were not present. Given that the inflammatory infiltrate was mainly localized perivascularly, the patient was diagnosed with eosinophilic annular erythema localized to the palms and soles. Conclusion: To our knowledge, only a few cases of EAE have been reported in the literature to date. EAE, though usually self-limited, can have a chronic relapsing and remitting course with a variable response to treatment. Both antimalarials and systemic steroids have been used for the treatment of the lesions. Given the rare presentation of EAE, we believe pathologists and dermatologists should be aware of this entity, its diagnosis, and treatment.

Financial Disclosure:
No current or relevant financial relationships exist.

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Zunaira Naeem, MD