Eosinophilic cellulitis is a rare condition characterized by recurrent pruritic or tender skin lesions. Biopsies usually display characteristic histologic features of dermal edema, eosinophils, and flame figures (collections of degranulated eosinophilic material). Eosinophilic cellulitis typically responds well to systemic steroids. However, oral steroids may be contraindicated in some patients. In addition, long-term use of systemic steroids can lead to steroid dependence as well as adverse effects on bone density, wound healing, and metabolism. Recent evidence in mice suggests that the tumor necrosis factor (TNF) pathway may play a role in antigen-specific IgE production and eosinophil recruitment.1 This suggests that TNF inhibitors may have some efficacy in the treatment of eosinophilic cellulitis.
Sarin KY, Fiorentino D. Treatment of Recalcitrant Eosinophilic Cellulitis With Adalimumab. Arch Dermatol. 2012;148(9):990–992. doi:10.1001/archdermatol.2012.114
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