Eosinophilic vasculitis: causes, symptoms, diagnosis, and treatment

Eosinophilic vasculitis is an eosinophil necrotizing vasculitis affecting small dermal vessels,less common in clinical practices, and is characterized by centripetal purpuric papules, angioedema, increased eosinophils in peripheral blood, and pathologically eosinophilic necrotizing vasculitis of small blood vessels.


Causes

The cause is unknown. Eosinophilic cytokines such as IL-5 and toxic eosinophil granule proteins such as major basic protein are found in the blood and tissues of patients with the disease, respectively, which may play a role in tissue damage. Neutrophil elastin is mainly in the peripheral blood vessels, and degranulation of mast cells is present.


Signs and Symptoms

Clinical manifestations are recurrent pruritic papules and wheals, with angioedema in the face and extremities. The disease can occur in any area of the skin, especially the head and neck, and can occur at any age, without gender differences. The disease can persist for a long time and can relapse, but there is no fever, arthralgia, and visceral involvement.


Histopathology

The disease has fibrinoid deposition and necrosis in the small blood vessels in the dermis, accompanied by eosinophil infiltration, with no or mild leukocytoclasis. There may be vesicles containing eosinophils in the epidermis. There is no deposition of immunoglobulins on and around the blood vessel wall.


Diagnosis

On the basis of clinical findings and histopathology, the disease can be diagnosed.


Treatment

Interstitial or persistent oral glucocorticoids may be given, depending on the response to treatment.