Eosinophils and associated parameters in different types of skin diseases related to elevated eosinophil levels

Background

Eosinophils, basophils, white blood cells (WBC), and immunoglobulin E (IgE) play major roles in the pathogenesis of atopic dermatitis (AD), bullous pemphigoid (BP), drug reaction with eosinophilia and systemic symptoms (DRESS), and hypereosinophilic syndrome (HES). This study aimed to describe these parameters in different skin diseases and provide further information concerning the underlying pathogenesis.

Methods

A cross-sectional study of blood test results, including WBC count, peripheral eosinophil count, peripheral basophil/WBC percentage, and IgE level, from 115 cases of AD, 75 cases of BP, 55 cases of DRESS, 119 cases of HES, and 621 healthy volunteers was performed in China. Data from before and after treatment and the population distribution of different diseases were compared and described.

Results

All participants showed increased peripheral eosinophil counts, eosinophil/WBC ratios, IgE levels, and decreased peripheral basophil counts, with variance among the different disease groups. Peripheral eosinophil counts in HES patients and IgE level in AD patients increased the most prominently. No significant correlation existed among eosinophils, basophils, and IgE. An obvious decrease in eosinophil count was demonstrated after treatment in all 4 diseases.

Conclusions

Eosinophils, basophils, and IgE exert functions in diverse skin diseases, presenting altered peripheral blood test results. In some cases, these changes are demonstrated only in the skin and not in the blood. Compared with the other parameters considered in this study, eosinophils seemed to be a better biomarker for treatment effects, regardless of the disease type.

A case of tripterygium glycosides-associated AGEP-like drug reaction combined with bullous pemphigoid

Acute generalized exanthematous pustulosis (AGEP) is a severe cutaneous drug reaction. Bullous pemphigoid (BP) is an acquired autoimmune disease that might be associated with drugs. There is currently no report of tripterygium glycosides (TG)-induced AGEP-like lesions combined with BP. A 66-year-old male with a 20-year history of psoriasis was prescribed oral TG at 1 mg/kg, three times a day, due to aggravated psoriasis. Seven days later, erythemas, and blisters appeared. After another 3 days, there were two types of blisters: (1) numerous small tension blisters with a lot of neutrophils on the top similar to AGEP combined with BP; (2) a BP. After intravenous injection of methylprednisolone and gamma globulin, the lesions were controlled. This patient developed two types of lesions, including one similar to AGEP combined BP (AGEP-like) and a BP. It is a rare drug reaction induced by TG.

Aquaporins and diseases pathogenesis: From trivial to undeniable involvements, a disease-based point of view

Aquaporins (AQPs), as transmembrane proteins, were primarily identified as water channels with the ability of regulating the transmission of water, glycerol, urea, and other small-sized molecules. The classic view of AQPs involvement in therapeutic plan restricted them and their regulators into managing only a narrow spectrum of the diseases such as diabetes insipidus and the syndrome of inappropriate ADH secretion. However, further investigations performed, especially in the third millennium, has found that their cooperation in water transmission control can be manipulated to handle other burden-imposing diseases such as cirrhosis, heart failure, Meniere's disease, cancer, bullous pemphigoid, eczema, and Sjögren's syndrome.