A case of eosinophilic panniculitis diagnosed in the lower extremity skin lesions with tenderness / 천식및알레르기

Eosinophilic panniculitis is characterized by prominent infiltration of eosinophils in the subcutaneous fat. Clinically it may be considered as a reactive process because most patients have an associated systemic condition. We report a case of tender subcutaneous nodules and plaques with erythema on the lower legs in a 30-year-old man with blood eosinophilia. The histologic features were characterized by massive eosinophilic infiltration in the septae and lobule in the parenchymal area of subcutaneous tissues. Despite exhaustive investigation, no obvious trigger of the panniculitis could be identified. The cutaneous lesions regressed and the eosinophil count became normal during the seven days course of treatment with intravenous corticosteroid. Another flare-up occurred about one month after treatment. The patient is presently being treated with prolonged use of alternate-day steroid without recurrence.

A case of Churg-Strauss syndrome associated with zafirlukast / 천식및알레르기

Churg-Strauss syndrome (CSS) is an eosinophil associated disease, characterized by vaculitis and granulomatosis on small vessel, asthma and eosinophil tissue infiltration. Several cases of CSS have been reported in patients treated with cysteinyl leukotriene receptor antagonist and weaned-off systemic or inhaled corticosteroids. A 39-year-old man with a history of childhood allergic rhinitis was diagnosed with bronchial asthma and his symptoms were well controlled with fluticasone propinate, salmeterol and zafirlukast. However four months later, he was admitted again with prominent skin lesions, tingling sensation on both extremities and fever. We diagnosed CSS with a history of sinusitis and bronchial asthma, marked peripheral eosinophilia, vasculitis and neuropathy. His symptoms and laboratory findings promptly improved after ten days of intravenous corticosteroid and cessation of zafirlukast without recurrence for six months during the follow-up period. We conclude that zafirlukast may cause CSS and attention should be taken when using zafirlukast.