Abstract
### Learning point for clinicians Severe eosinophilic dermatitis with systemic symptoms is rare. We report, for the first time, that the systemic clinical symptoms and high CRP (123 mg/l) were due to an IL-6 and IL-8 cytokine storm. Systemic disease control was only achieved with high dose oral prednisolone, topical triamcinolone to affected skin and dapsone. A 27-year-old woman presented with a 12-day history of worsening fever and rash. Erythematous, indurated and pruritic lesions had been developing on her inner thighs. They went on to spread to her arms and back. She was previously fit and well with no relevant past medical or family history. During her first week in hospital, she became intermittently confused and disorientated and was also intermittently febrile between 38.3°C and 40°C. Her skin lesions became ‘woody hard’ subcutaneous swelling and were associated with dark mottling of the overlying skin. During her second week in …
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