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Dermal flame figures

MedGen UID:
1053474
•Concept ID:
CN376602
•
Finding
HPO: HP:6000090

Definition

Flame-figures are composed of a central part consisting of collagen fibers and eosinophilic granules, surrounded by a histiocytic and eosinophilic infiltrate. Subsequently, eosinophils tend to disappear and are replaced by phagocytic granulomas, consisting of histiocytes and sometimes giant cells, around the flame figures. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVDermal flame figures

Recent clinical studies

Etiology

An infant with bullous pemphigoid.
Santos AL, Mota AV, Ramon J, Lopes JM, Azevedo F
Dermatol Online J 2007 Jul 13;13(3):17. PMID: 18328211
Gnathostomiasis: clinicopathologic study.
Magaña M, Messina M, Bustamante F, Cazarín J
Am J Dermatopathol 2004 Apr;26(2):91-5. doi: 10.1097/00000372-200404000-00001. PMID: 15024188
Wells' syndrome: a clinical and histopathologic review of seven cases.
Moossavi M, Mehregan DR
Int J Dermatol 2003 Jan;42(1):62-7. doi: 10.1046/j.1365-4362.2003.01705.x. PMID: 12581147
Flame figures associated with bullous pemphigoid.
Watanabe H, Sueki H, Kitami A, Kakuchi C, Ikeda Y, Nagata S, Hashimoto T, Iijima M
J Dermatol 1998 Oct;25(10):632-6. doi: 10.1111/j.1346-8138.1998.tb02471.x. PMID: 9830260

Diagnosis

Luna stain: a simple and cost-effective diagnostic tool helps in detecting eosinophilic granules deposition of flame figures and aids in diagnosing eosinophilic cellulitis "Wells Syndrome".
Mejbel HA, Preiszner J, Shurbaji MS, Leicht SS, Youngberg GA
J Histotechnol 2020 Dec;43(4):196-199. Epub 2020 Oct 14 doi: 10.1080/01478885.2020.1818456. PMID: 33245262
Flame figures in linear IgA bullous dermatosis: a novel histopathologic finding.
Fulton E, Jan F, Zimarowski MJ
Dermatol Online J 2017 Nov 15;23(11) PMID: 29447641
Eosinophilic annular erythema: A late but complete response to hydroxychloroquine.
Karataş Toğral A, Seçkin D
Australas J Dermatol 2017 Aug;58(3):228-230. Epub 2016 Jan 14 doi: 10.1111/ajd.12445. PMID: 26768795
Gnathostomiasis: clinicopathologic study.
Magaña M, Messina M, Bustamante F, Cazarín J
Am J Dermatopathol 2004 Apr;26(2):91-5. doi: 10.1097/00000372-200404000-00001. PMID: 15024188
Eosinophilic infiltration with flame figures. A distinctive tissue reaction seen in Wells' syndrome and other diseases.
Wood C, Miller AC, Jacobs A, Hart R, Nickoloff BJ
Am J Dermatopathol 1986 Jun;8(3):186-93. doi: 10.1097/00000372-198606000-00002. PMID: 3728877

Therapy

Flame figures in linear IgA bullous dermatosis: a novel histopathologic finding.
Fulton E, Jan F, Zimarowski MJ
Dermatol Online J 2017 Nov 15;23(11) PMID: 29447641
Eosinophilic annular erythema: A late but complete response to hydroxychloroquine.
Karataş Toğral A, Seçkin D
Australas J Dermatol 2017 Aug;58(3):228-230. Epub 2016 Jan 14 doi: 10.1111/ajd.12445. PMID: 26768795
An infant with bullous pemphigoid.
Santos AL, Mota AV, Ramon J, Lopes JM, Azevedo F
Dermatol Online J 2007 Jul 13;13(3):17. PMID: 18328211
Gnathostomiasis: clinicopathologic study.
Magaña M, Messina M, Bustamante F, Cazarín J
Am J Dermatopathol 2004 Apr;26(2):91-5. doi: 10.1097/00000372-200404000-00001. PMID: 15024188
Wells' syndrome: a clinical and histopathologic review of seven cases.
Moossavi M, Mehregan DR
Int J Dermatol 2003 Jan;42(1):62-7. doi: 10.1046/j.1365-4362.2003.01705.x. PMID: 12581147

Prognosis

Luna stain: a simple and cost-effective diagnostic tool helps in detecting eosinophilic granules deposition of flame figures and aids in diagnosing eosinophilic cellulitis "Wells Syndrome".
Mejbel HA, Preiszner J, Shurbaji MS, Leicht SS, Youngberg GA
J Histotechnol 2020 Dec;43(4):196-199. Epub 2020 Oct 14 doi: 10.1080/01478885.2020.1818456. PMID: 33245262
An infant with bullous pemphigoid.
Santos AL, Mota AV, Ramon J, Lopes JM, Azevedo F
Dermatol Online J 2007 Jul 13;13(3):17. PMID: 18328211
alpha1-Antitrypsin deficiency presenting with panniculitis and incidental discovery of chronic obstructive pulmonary disease.
Korver G, Liu C, Petersen M
Int J Dermatol 2007 Oct;46(10):1078-80. doi: 10.1111/j.1365-4632.2006.03067.x. PMID: 17910720
Wells' syndrome: a clinical and histopathologic review of seven cases.
Moossavi M, Mehregan DR
Int J Dermatol 2003 Jan;42(1):62-7. doi: 10.1046/j.1365-4362.2003.01705.x. PMID: 12581147

Clinical prediction guides

Eosinophilic annular erythema: A late but complete response to hydroxychloroquine.
Karataş Toğral A, Seçkin D
Australas J Dermatol 2017 Aug;58(3):228-230. Epub 2016 Jan 14 doi: 10.1111/ajd.12445. PMID: 26768795
An infant with bullous pemphigoid.
Santos AL, Mota AV, Ramon J, Lopes JM, Azevedo F
Dermatol Online J 2007 Jul 13;13(3):17. PMID: 18328211
alpha1-Antitrypsin deficiency presenting with panniculitis and incidental discovery of chronic obstructive pulmonary disease.
Korver G, Liu C, Petersen M
Int J Dermatol 2007 Oct;46(10):1078-80. doi: 10.1111/j.1365-4632.2006.03067.x. PMID: 17910720
Eosinophilic cellulitislike reaction to subcutaneous etanercept injection.
Winfield H, Lain E, Horn T, Hoskyn J
Arch Dermatol 2006 Feb;142(2):218-20. doi: 10.1001/archderm.142.2.218. PMID: 16490850
Flame figures associated with bullous pemphigoid.
Watanabe H, Sueki H, Kitami A, Kakuchi C, Ikeda Y, Nagata S, Hashimoto T, Iijima M
J Dermatol 1998 Oct;25(10):632-6. doi: 10.1111/j.1346-8138.1998.tb02471.x. PMID: 9830260

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