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Int J Clin Exp Pathol 2013;6(8):1683-1687

Case Report
Flame figures associated with eosinophilic dermatosis of hematologic malignancy: is it
possible to distinguish the condition from eosinophilic cellulitis in patients with
hematoproliferative disease?

Jianjun Qiao, Chang-E Sun, Weifang Zhu, Dingxian Zhu, Hong Fang

Department of Dermatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China

Received May 31, 2013; Accepted July 1, 2013; Epub July 15, 2013; Published August 1, 2013

Abstract: Eosinophilic dermatosis of hematologic malignancy is a multifaceted dermatosis with a wide morphological spectrum, presenting
as pruritic, erythematous, papular and occasionally vesicular, urticarial, nodular eruptions. Histopathologically eosinophil infiltration in the
super and deep dermis was found. We reported a case of eosinophilic dermatosis of hematologic malignancy presented as urticarial and
vesicular lesions in a patient with chronic lymphocytic leukemia. A skin biopsy revealed a prominent subepidermal blister and a diffuse infiltrate
of eosinophils with flame figures in the dermis and subcutaneous tissue. Although flame figures associated with eosinophilic dermatosis of
hematologic malignancy is rarely reported, we believe that it would not seem unusual to find them in this skin disease. Eosinophilic cellulitis,
which share clinical and histological features with eosinophilic dermatosis of hematologic malignancy, has also been described as showing
an association with hematoproliferative diseases. In order to clearly describe eosinophilic dermatosis in patients with hematologic
malignancies, the terminology eosinophilic dermatosis of hematologic malignancy, instead of eosinophilic cellulitis, would be a more suitable
term in patients with eosinophilic dermatosis. (IJCEP1305038).

Keywords: Eosinophilic dermatosis, hematologic malignancy, flame figures, chronic lymphocytic leukemia

Address correspondence to: Dr. Hong Fang, Department of Dermatology, The First Affiliated Hospital, College of Medicine, Zhejiang
University, No. 79, Qingchun Road, Hangzhou, 310003, Zhejiang Province, People’s Republic of China. Phone: +86-571-87236385; Fax: +86-
571-87236385; E-mail: fanghongzy@sina.com