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Eosinophilic leukocytoclastic vasculitis – a spectrum ranging from Wells’ syndrome to Churg-Strauss syndrome?

Authors :
Gudrun Ratzinger
Bernhard Zelger
Klaus Eisendle
Julia Zankl
Source :
European Journal of Dermatology. 24:603-610
Publication Year :
2014
Publisher :
John Libbey Eurotext, 2014.

Abstract

Background: Wells’ syndrome is defined as an inflammatory disorder with the histopathological presence of eosinophilic infiltrates and flame figures in the absence of vasculitis. Eosinophilic leukocytoclastic vasculitis shows eosinophilic infiltrates in combination with vasculitic changes. And Churg Strauss Syndrome comprises all three characteristics – eosinophilic infiltrates, vasculitis and flame figures. Objective: To determine whether these three diseases are distinct entities or different manifestations of a similar clinicopathologic process. Method: Histopathological samples and clinical courses of 17 patients with eosinophilic infiltrates, flame figures and clinical features of Wells’ syndrome were re-evaluated. Histopathologically, we focused on the presence or absence of vasculitic features. Clinically, we included only patients who were diagnosed with Wells’ syndrome at least once in the course of their disease. Results: 4 patients were finally diagnosed with Wells’ syndrome, 5 with eosinophilic leukocytoclastic vasculitis and 6 with Churg Strauss syndrome. Further, we had one case of an overlap between Wells’ syndrome and eosinophilic vasculitis and one case of Wegener granulomatosis. Vasculitic features were found in the samples of all patients. Conclusions: Histologically, we find vasculitic features in typical presentations of Wells’ syndrome. Clinically, we find typical features of Wells’ syndrome in patients finally diagnosed with eosinophilic leukocytoclastic vasculitis or Churg Strauss syndrome. Furthermore, we have observed and formerly reported 3 patients with progression from Wells’ syndrome to Churg Strauss syndrome. Thus, we assume that eosinophilic leukocytoclastic vasculitis might form a bridge between Wells’ syndrome and Churg Strauss syndrome.

Details

ISSN :
19524013 and 11671122
Volume :
24
Database :
OpenAIRE
Journal :
European Journal of Dermatology
Accession number :
edsair.doi.dedup.....c1d9741d6ca6e5b7e9c0d16f3afe15aa
Full Text :
https://doi.org/10.1684/ejd.2014.2411