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Annales de Dermatologie et de Vénéréologie
Vol 128, N° 4  - juin 2001
p. 545
Doi : AD-04-2001-128-4-0151-9638-101019-ART13
Cas cliniques

Artérite éosinophilique du cuir chevelu
 

E. Grosshans [1], P.-H. Asch [1]
[1] Clinique Dermatologique des Hôpitaux Universitaires de Strasbourg, Faculté de Médecine, Université Louis Pasteur, Strasbourg.

Abstract
Introduction

La survenue par poussées de lésions de thrombose artérielle périphérique associées à une éosinophilie sanguine suggère généralement l'existence d'une vasculopathie oblitérante ou d'une vasculite systémique.

Observation

Chez une femme de 31 ans, dans un contexte de tabagisme de 10 paquets/année et d'éosinophilie de 1 200 à 2 500/mm 3 , sont survenus des accès de prurit et d'urticaire et des lésions d'artérite éosinophilique oblitérante du cuir chevelu. Malgré la persistance de l'éosinophilie, l'évolution a été spontanément favorable, sans aucune complication pendant une période d'observation de 3 ans.

Discussion

La maladie de Buerger et les vasculites systémiques, notamment le syndrome de Churg et Strauss, peuvent comporter une hyperéosinophilie et des lésions initiales de thromboangéite des artères du cuir chevelu. Ce sont la normalité des explorations vasculaire et biologique et l'évolution favorable, même sans corticothérapie générale et malgré la persistance de l'éosinophilie sanguine, qui permettent d'éliminer ces diagnostics, de retenir chez cette malade celui d'artérite éosinophilique du cuir chevelu et de confirmer l'existence de cette entité anatomoclinique.

Abstract
Eosinophilic arteritis of the scalp.
Background

The occurrence of recurrent peripheral arterial thromboses together with a blood eosinophilia generally suggests an occlusive vascular disease or a systemic vasculitis.

Case report

In a 31-year-old woman with a 15-year history of severe smoking and a blood eosinophilia from 1,200 to 2,500/mm 3 , we observed recurrent attacks of pruritus and urticaria and recurrent lesions of eosinophilic thromboangiitis of hypodermal medium-sized elastic arteries of the scalp. In spite of the persistent eosinophilia, the evolution was spontaneously regressive and no other clinical or biological sign occurred within a follow-up time of 3 years.

Discussion

In Buerger's disease (thromboangiitis obliterans) and in most systemic vasculitis, especially in Churg-Strauss syndrome, the first lesions may be inflammatory thromboses of the extra-cranial scalp arteries. The diagnosis of an eosinophilic arteritis of the scalp may only be considered if the examination of the other peripheral vessels is normal and if the course of the disease is benign, without any treatment, in spite of a persistent blood eosinophilia. This clinico-pathological presentation should be considered as a distinct entity.






© 2001 Elsevier Masson SAS. Tous droits réservés.
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