Treatment of Eosinophilic Annular Erythema: Retrospective multicenter study and literature review

Background: Eosinophilic annular erythema (EAE) is a rare eosinophil-related skin disease which typically manifests with annular erythematous plaques and severe pruritus. Besides the diagnosis, the treatment of EAE is challenging since relevant published data are sparse. Methods: The aim of this study was to assess the underlying diseases, treatments and outcomes of patients with EAE. To this end, we conducted a retrospective multicenter study and a systematic review of the MEDLINE database. Results: We included 18 patients with EAE followed in 8 centers. The MEDLINE database search yielded 37 relevant publications reporting 55 cases of EAE with 106 treatment sequences. The most common and efficient treatments included topical or systemic corticosteroids, hydroxychloroquine and dapsone. In refractory patients, a combination of systemic corticosteroids with hydroxychloroquine was associated with 88% of complete clinical response. Discussion: To improve the management of EAE patients, we discuss the following treatment strategy: in topical steroid-resistant patients, hydroxychloroquine can be given as first-line systemic treatment. Dapsone, hydroxychloroquine or systemic corticosteroids are second-line options to consider. Last, monoclonal antibodies or JAK inhibitors targeting type 2 inflammation could represent promising last-resort options in refractory patients. (c) 2021 Elsevier Masson SAS. All rights reserved.

Automated summary

This study investigated the underlying diseases, treatments, and outcomes of patients with eosinophilic annular erythema (EAE). The results showed that topical or systemic corticosteroids, hydroxychloroquine, and dapsone were the most common and efficient treatments. In refractory patients, a combination of systemic corticosteroids with hydroxychloroquine achieved a high complete clinical response rate.