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Skin biopsy showed perivascular and perifollicular lymphohistiocytic inflammatory infiltrate with eosinophilic granules. What is this?

Jul 2012
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Practicing since : 1993
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I had a skin biopsy which showed perivascular and perifollicular lymphohistiocytic inflammatory infiltrate with admixture of eosinophilic granules in the facial dermis. Would welcome some thoughts as to what you may think the possibilities this may be / being caused by.
Posted Wed, 19 Sep 2012 in Skin Hair and Nails
Answered by Dr. Praveen Rodrigues 4 hours later
Hi there. At the outset may i say Dublin is a fine place & my sister & her family hold an Irish passport so am touch partial to the Dubliners & Temple Bar!
I note your particular problem with interest & note the findings of your skin biopsy & histopathology. A host of skin ailments may present with a similar histopathological picture largely centred around a 'eosinophilc vasculitis' kind of picture. Agreed dust mites may not be your best friend, but please do remember more than one allergens are very possible in what to me seems like an 'atopic' individual. In this particular instance, i would go with airborne allergens & however eco-friendly the greenery around Dublin may be, it is very likely some airborne allergens coupled with UV exposure (not necessarily only sunlight) may be aggravating your particular problem. Another possibility is food/drugs (medications)..that can explain both the urticaria & this problem. I recommend locating a large hospital with a good dermatology department in Dublin wherin, patch/prick tests are conducted routinely for allergies & fixing up an appointment & at the same time, perhaps you can keep a 'diet diary' wherin you score your lesions on a scale of 1-10 (redness, scaling,itchsymptoms) & avoid one food each 2 weeks from your regular milk & all milk products including bakery items, egg, fish, chocolates, nuts..these are the major known incriminated parties but you may be allergic to food/food additives. Again a point to note is that some allergens may be found in more than one form (air/food/water etc) & it may be prudent to keep a watch. I note you are probably under treatment & enquired only to get in additional views to help sort the issue so will leave it at this. Perhaps we can re-connect in a month & re-evaluate if you care to.
Wish you good health & hope this resolves soon & you are itch free!
Dr Praveen Rodrigues MD
Dermatologist, Cosmetologist, Venereologist
Bangalore, India
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