Nodules, Eosinophilia, Rheumatism, Dermatitis and Swelling (NERDS)

 

Clinical features:

(1) nodules, often para-articular

(2) eosinophilia

(3) rheumatism (joint pain with tenosynovitis)

(4) dermatitis (urticaria and dermatographism)

(5) swelling (angioedema) of hands and feet

 

Other findings may include:

(1) episcleritis

(2) xerosis

 

Biopsy of a nodule shows necrotizing granulomas, non-specific vasculitis, mast cells and eosinophils. The lesions show deposition of major basic protein (MBP) from eosinophils.

 

The clinical course is relatively benign.