Lymphomas, Skin Diseases, and Hypereosinophilia

Dermatologists frequently find eosinophilia associated with skin disease, but is it dangerous or indicative of lymphoma or leukemia?

Hypereosinophilic syndrome (HES) is defined by presence of persistent blood eosinophilia (hypereosinophilia [HE] count >1.5 g/L) or tissue eosinophilia; organ damage or dysfunction attributable to tissue HE; and exclusion of other explanations for organ dysfunction. In primary (neoplastic or lymphoid) HES, eosinophils are clonal (chronic eosinophilic leukemia, a myeloid disorder, or both). In secondary (reactive) HES, eosinophilic expansion has been induced by eosinophilopoietic cytokines. Usually a Th2 T-cell subset of lymphocytes overproduces interleukin-5. A few patients with secondary HES evolve to develop T-cell lymphomas.

A retrospective study of 21 patients found 48% had an atopic history (eczema, asthma, or rhinosinusitis). Skin find…

Reviewing Author

Mark V. Dahl, MD

Disclosures

Consultant / Advisory board Ulthera, Inc.; AuBio LifeSciences, LLC; Paris Therapeutics

Equity Elorac, Inc.; Makucell, Inc.; Paris Therapeutics

Editorial boards UpToDate

Leadership positions in professional societiesNational Rosacea Society (Chairman, Medical Board)