Elevated eosinophil raised itchy patches on skin and basophil counts – hematology

Bacterial and viral infections are both unlikely ever to lead raised itchy patches on skin to eosinophilia except in a few patients with scarlet fever, mononucleosis, or infectious lymphocytosis. The second most common group of causes of eosinophilia are raised itchy patches on skin allergic conditions: these include asthma, hay fever, and various dermatoses ( urticaria, psoriasis). This second group also includes drug-induced hypersensitivity with its almost infinitely multifarious triggers, among which various antibiotics, gold preparations, hydantoin derivatives, phenothiazines, and dextrans appear to be the most prevalent. Eosinophilia is also seen in autoimmune diseases, especially in scleroderma and panarteritis. All neoplasias can lead to "paraneoplastic" eosinophilia, and in hodgkin’s disease it appears to play a special role in raised itchy patches on skin the pathology, although it is nevertheless not always present.

A specific hypereosinophilia syndrome with extreme values (usually > 40%) is seen clinically in association with various combinations of splenomegaly, heart defects, and pulmonary infiltration (loeffler syndrome), and is classified somewhere between autoimmune diseases and myeloproliferative syndromes. Of the leukemias, CML usually manifests moderate eosinophilia in addition to its other raised itchy patches on skin typical criteria (see p. 114). When moderate eosinophilia dominates the hematological picture, the term chronic eosinophilic leukemia is used. Acute, absolute predominance of eosinophil blasts with concomitant decrease in neutrophils, erythro-cytes, and thrombocytes suggests the possibility of the very rare acute raised itchy patches on skin eosinophilic leukemia.

Elevated basophil counts. Elevation of segmented basophils to more than 2-3% or 150/^1 is rare and, in accordance with their physiological role in the immune system raised itchy patches on skin regulation, is seen inconsistently in allergic reactions to food, drugs, or parasites (especially filariae and schistosomes), i.E., usually in conditions in which eosinophilia is also seen. Infectious diseases that may show basophilia are tuberculosis and chickenpox; metabolic diseases where basophilia may occur are myxedema and hyperlipidemia. Au-tonomic proliferations of basophils are part of the myeloproliferative a raised itchy patches on skin b c

Fig. 43 eosinophilia and basophilia. A screening view of blood cells in reactive eosinophilia: eosinophilic granulocytes (1), segmented neutrophilic granulocyte (2), and monocyte (3) (reaction to bronchial carcinoma). B and cthe image shows an eosinophilic granulocyte (1) and a basophilic granulocyte (2) (clinical osteomyelosclerosis). D bone marrow in systemic mastocytosis: tissue mast cell (3), which, in contrast to a basophilic granulocyte, has an unlobed nucleus, and the cytoplasm is wide with a tail-like extension. Tissue mast cells contain intensely basophilic granules. 125

Fig. 43 eosinophilia and basophilia. A screening view of blood cells in reactive eosinophilia: eosinophilic granulocytes (1), segmented neutrophilic granulocyte (2), and monocyte (3) (reaction to bronchial carcinoma). B and cthe image shows an eosinophilic granulocyte (1) and a basophilic granulocyte (2) (clinical osteomyelosclerosis). D bone marrow in systemic mastocytosis: tissue mast cell (3), which, in contrast to a basophilic granulocyte, has an unlobed nucleus, and the cytoplasm is wide with a tail-like extension. Tissue mast cells contain intensely basophilic granules. 125

Being an expression of idiopathic disturbance of bone marrow function, elevated basophil counts are a relatively constant phenomenon in myeloproliferative raised itchy patches on skin syndromes (in addition to the specific signs of these diseases), especially in CML. Acute basophilic leukemia is extremely rare; in this condition, some of the dedifferentiated blasts contain more or less ba-sophilic granules.

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