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Eosinophilic granuloma, small nodules on left elbow, thigh, knee, skin lesions. Treatment ?

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XXXXXXX male, 35, 68kg, 170cm, indian suffering from eosinophilic granuloma. Small nodules of about 1/2 cm have appeared on many parts of body especially left elbow, thigh, knee, etc.
Posted Sat, 5 May 2012 in Skin Hair and Nails
Answered by Dr. Bharat Chawda 4 hours later

Thank you for posting the query,

As you said, you are suffering from Eosinophilic Granuloma, which can involve respiratory system to bones. It can also have skin lesions which manifest as small red to salmon colored nodules over abdomen and thighs .
The condition is also called Langerhans histiocytosis.

You haven't specified your question, so I probably guess that you are looking out for treatment of the same.

The only treatment recommended is either Steroid (injectable if lesions are few) and Cyclosporin.

I would like to know what treatment you are on and what other symptoms you are having.

I will be able to answer more precisely after your reply to above questions.

Hope I have answered your query.


Dr.Bharat chawda
Above answer was peer-reviewed by
Follow-up: Eosinophilic granuloma, small nodules on left elbow, thigh, knee, skin lesions. Treatment ? 2 days later
Thanks for ur reply.
Actually i wanted to know if there is any other treatment possible other than taking steroids [which has very bad effects, if taken for a longer period].
Actually i think that taking steroids is like running towards death for saving life!
Pls explain steroidal treatment & its possible side effects.
I have developed skin lesions on my thigh, calf & near elbow.
Awaiting ur reply, XXXXXXX 0000
Answered by Dr. Bharat Chawda 3 hours later

Thank you for writing back.

You are right about steroids which is some thing like a double edged sword. But being a Dermatologist, I can say that if steroids are monitored properly the side effects can be controlled pretty effectively.

If lesions are very few, then intralesional steroids (injecting in to the lesion) are better, with very negligible side effects.

Long term steroid can reduce the immune system of the body and patient gets prone to Hypertension and Diabetes. At times the body gets addicted to steroid, if the doses are not properly monitored. Once steroid are started one should see that it is not abruptly stopped. The dosage needs to be gradually tapered.

The other drug recommended is Cyclosporine, which is a immunosuppressant, leaving patients vulnerable to infections and other problem.

So, I would suggest you to consult a competent Dermatologist or a Hematologist, who can supervise your treatment properly.

‘Hope I have answered your query'.

Wish you good health.


Above answer was peer-reviewed by
Follow-up: Eosinophilic granuloma, small nodules on left elbow, thigh, knee, skin lesions. Treatment ? 1 hour later
Hello Dr. Bharat!
Thanks again!.
Actually I am consulting a few dermatologists in Pune & Mumbai.
As per one opinion its is suggested to be Gnathostomiasis, which is a parasitic condition.
But many others have overruled that.
I even took Ivermectin & Albandazole [ BD for 10 days. Actually it was recommended for 21 days ].
I have been asked to overrule the possibility of Gnathostomiasis again by doing ELISA for Gnathostomiasis for antigen. [No worms were seen in biopsy]
This test is not done in India. Pls suggest some overseas location which may do it.
Warm Regards.
Answered by Dr. Bharat Chawda 4 hours later

Thank you for the follow up,

Gnathostomiasis is a round worm infection which when involves the skin causes cutaneous larva migrans .In this one gets to see migratory, painful, pruritic swellings in the skin .There can be stabbing pain as well.These worms can also involve other organs of the body causing hematuria (blood in urine) ,eye involvement, cough etc.Your eosinophils would be raised in this. You can also get a urine test done to find detect microscopic hematuria.

You are absolutely right regarding the medicines ,like albendazole which needs to be taken for 21 days.

Regarding ELISA test you need to check out at any of the parasitology department. If I am not wrong ,then any of the good hospitals in south Asia would be doing these tests .

You can find out at following places :
1) Department of Parasitology, Faculty of Medicine, Hiroshima University, Japan.
2) Department of Parasitology, Faculty of Medicine, Khon Kaen University, Thailand.
3) Department of Parasitology and Tropical Medicine, Seoul National University College of Medicine, and Institute of Endemic Disease, Seoul National University Medical Research Center, Seoul 110-799, Republic of Korea, E-mail: YYYY@YYYY .

CT scanning or MRI can also be used to help identify a soft tissue worm.

I would advise you to google out these above places and find out if they are doing ELISA for the same.

I hope that the above information would be helpful to you.Should you have additional concerns regarding this issue I would be happy to address them.

“ Wish you Good Health”

Dr.Bharat chawda
Above answer was peer-reviewed by
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