By Gary M. White, MD

Churg-Strauss syndrome

Churg-Strauss syndrome (CSS), aka eosinophilic granulomatosis with polyangiitis, is a multi-organ systemic vasculitis characterized by tissue and blood eosinophilia.


Skin changes are variable and include an erythematous maculopapular eruption, hemorrhagic lesions, sometimes accompanied by necrosis, and cutaneous and subcutaneous nodules.

In one study [JAAD 1997;37;199], 40% of patients had skin findings and the most frequent were purpura and petechiae on the legs and cutaneous nodules and papules on the elbows.


Consultation with a rheumatologist is in order. In the past, prednisone e.g., 60-100 mg/day, has been used first. Cyclophosphamide has been added if needed.  Mycophenolate mofetil was used successfully.

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Churg-Strauss syndrome

Churg-Strauss syndrome Churg-Strauss syndrome Churg-Strauss syndrome


A 53-year-old patient presented with a history of recently diagnosed and worsening asthma with nasal polyposis. A mononeuritis and a vasculitic rash were noted and blood screen showed hypereosinophilia and immunoglobulin E (IgE) elevation. BMJ Case Rep. 2011;


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