Oral tacrolimus for severe recalcitrant eosinophilic cellulitis

Eosinophilic cellulitis (EC) is an uncommon benign inflammatory dermatosis, primarily described by Wells in 1971 as “recurrent granulomatous dermatitis with eosinophilia.”1 Despite its benign nature, EC has a significant deleterious effect on quality of life due to severe pruritus in many cases. Systemic corticosteroids are commonly used as the first-line therapy.2 Prolonged therapy however is limited due to significant side effects. Other treatment modalities include cyclosporine, dapsone, antihistamines, interferon alfa/gamma, anti–tumor necrosis factor-alfa, psoralen plus ultraviolet A, colchicine, antimalarials, azathioprine, minocycline, and griseofulvin.