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Splendore-Hoeppli phenomenon

Monday 3 April 2017

Definition: Splendore-Hoeppli phenomenon (asteroid bodies) is the in vivo formation of intensely eosinophilic material (radiate, star-like, asteroid or club-shaped configurations) around microorganisms (fungi, bacteria and parasites) or biologically inert substances.

Images

- Splendore-Hoeppli phenomenon

- basiobolomycosis mimics clinical features of Crohn disease; eosinophils, granulomatous inflammation, Splendore-Hoeppli, & CL crystals

Several mucocutaneous infections can generate Splendore-Hoeppli reaction.

The fungal infections include sporotrichosis , pityrosporum folliculitis , zygomycosis , candidiasis , aspergillosis , basiobolomycosis , blastomycosis.

The bacterial infections include botryomycosis , nocardiosis and actinomycosis .

The parasitic conditions include orbital pythiosis , strongyloidiasis , schistosomiasis and cutaneous larva migrans .

Splendore-Hoeppli reaction may be seen with non-infective pathology such as hypereosinophilic syndrome and allergic conjunctival granulomas. The Splendore-Hoeppli reaction material comprises antigen-antibody complex, tissue debris and fibrin.

Although the exact nature of this reaction is unknown, it is thought to be a localized immunological response to an antigen-antibody precipitate related to fungi, parasites, bacteria or inert materials.

The characteristic formation of the peribacterial or perifungal Splendore-Hoeppli reaction probably prevents phagocytosis and intracellular killing of the insulting agent leading to chronicity of infection.

Splendore-Hoeppli reaction is a tell tale of a spectrum of infections and reactive conditions. The molecular pathways involved in the development of this reaction are open for future investigations.

Refererences

- Mucocutaneous Splendore-Hoeppli phenomenon.
Hussein MR.
J Cutan Pathol. 2008 Nov;35(11):979-88. doi : 10.1111/j.1600-0560.2008.01045.x. Review
PMID: 18976399