Steven brown, university of pittsburgh school of medicine answered may. Bullous eosinophilic cellulitis wells syndrome associated with churgstrauss syndrome. Wells syndrome successfully treated with colchicine fulltext. Icd10 diagnosis procedures transplants select imaging. Diagnosis and management of eosinophilic cellulitis wells.
Eosinophilic cellulitis wells syndrome caused by a temporary henna tattoo article pdf available in postepy dermatologii i alergologii 315. Scar formation does not typically occur eosinophilic cellulitis is of unknown cause. Eosinophilic cellulitis in a patient with gastric cancer article pdf available in acta dermatovenereologica 896. Eosinophilic cellulitis ec, also known as wells syndrome, is a rare. Eosinophilic cellulitis wells 1979 british journal. Cellulitis is an infection of the skin caused by bacteria, usually staphylococcus aureus also called staph and group a beta haemolytic streptococcus. Typically eosinophilic cellulitis is preceded by itching or burning skin. Eosinophilic cellulitis is an uncommon, inflammatory and chronic. Eosinophilic cellulitis and dermographism nathalie q nguyen md and linglei ma md phd dermatology online journal 11 4. Eosinophilic cellulitis or wells syndrome is a rare dermatosis of unclear etiopathogenesis. Files are available under licenses specified on their description page. Although most cases of wells syndrome occur in adults, we present a child with these clinical and histopathologic findings.
Pdf most of the documents on the racgp website are in portable document format pdf. Eosinophilic cellulitis definition of eosinophilic. Misdiagnosis leads to delay of correct treatment and inappropriate use of antibiotics. Two pediatric cases with positive patch test to aluminium salts. We would like to show you a description here but the site wont allow us. Eosinophilic cellulitis wells syndrome is a rare disorder characterized clinically by recurrent erythematous plaques resembling cellulitis and histologically by a dermal infiltrate of lymphocytes, eosinophils and eosinophil debris between collagen bundles, forming flame figures in typical cases. It presents with markedly swollen nodules and plaques lumps with prominent borders. Subsequently, granulomatous features with characteristic flame figures become apparent. The patient presented with papules and pruritus of the lower limbs of more than 1 month duration, and with angioedema and intensively pruritic, necrotizing lesions of the bilateral anterior tibias and feet for 2 weeks. The symptoms generally come on rapidly and may last four to eight weeks. Information and translations of eosinophilic cellulitis in the most comprehensive dictionary definitions resource on the web. Pdf successful treatment of eosinophilic cellulitis with dapsone.
Eosinophilic cellulitis ec, or wellssyndrome, was first described by wells in 1971 1. Affected people typically develop a skin rash that is often preceded by itching or burning skin. Living with eosinophilic cellulitis deceptively blonde. Cincinnati center for eosinophilic disorders genetic and. These files will have pdf in brackets along with the filesize of the download. Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126. Wells syndrome and its relationship to churgstrauss syndrome. The data is not an icd10 conversion tool and doesnt guarantee clinical accuracy. Bullous pemphigoid, dermatitis herpetiformis erythema toxicum neonatorum hyper ige syndrome eosinophilic cellulitis wells sy, hypereos sy neoplasms histiocytosis, chronic eosinophilic. Idiopathic bullous eosinophilic cellulitis wells syndrome. A thirtyfiveyearold female presented with 2 weeks history of gradually progressive and painful erythematous plaque on the right foot. Cutaneous lesions are variable in appearance and may be confused with cellulitis, urticaria. It usually occurs in the loose tissues beneath the skin, but may also occur in tissues beneath.
Wells syndrome is a rare and idiopathic entity whose treatment can be. A 26yearold man presented with a history of intermittent erythematous plaques on his hands and legs. Recurrent cutaneous necrotizing eosinophilic vasculitis. Wells syndrome is a rare disease in which there are itchy, burning, red and inflamed areas that can occur anywhere on the skin. Several treatment modalities have been used to treat eosinophilic cellulitis and have been met with variable success rates. Eosinophilic cellulitis wells syndrome fisher 1985. Eosinophilic cellulitis an overview sciencedirect topics. Clinically overt toxocariasis is uncommon in adults, yet helminthozoonoses, including toxocariasis have been occasionally implicated in the pathogenesis of eosinophilic cellulitis.
Definition of eosinophilic cellulitis in the dictionary. Familial eosinophilic cellulitis is a rare skin disorder. The bacteria enter your body when you get an injury such as a bruise, burn, surgical cut, or wound. The histology is distinctive with focal phagocytosis of eosinophilic material in the dermis. Cutaneous lesions are variable in appearance and may be confused with cellulitis, urticaria, insect bites, or contact dermatitis. Microscopically, there is a dense dermal infiltrate of eosinophils. Wells syndrome, or eosinophilic cellulitis, is a rare disorder characterized by erythematous plaques evolving into dermal or subcutaneous masses. It is often associated with infectious, allergic or myeloproliferative diseases. Wells syndrome genetic and rare diseases information. If you have problems viewing pdf files, download the latest version of adobe reader. Eosinophilic cellulitis wells syndrome, international. It is characterized by development of indurated areas of erythema, usually on a distal limb, which may be single or multiple.
Eosinophilic cellulitis wells syndrome is a polyetiologic clinical entity with still obscure pathogenesis. After one year of followup the patient was relapsefree. Patients with toe web intertrigo andor tinea pedis and those with lymphatic obstruction, venous insufficiency, pressure ulcers, and obesity are. The patches are usually bright red at first, frequently looking like cellulitis, then fade over four to eight weeks, leaving green. Distinguishing cellulitis from its mimics abstract distinguishing true cellulitis from its many imitators is challenging but critical if we are to avoid unnecessary use of antibiotics and delays in treatment. All structured data from the file and property namespaces is available under the creative commons cc0 license.
The first phase begins with prodromal symptoms of pain and burning followed by the development of plaques that expand centrifu. Eosinophilic cellulitis wells syndrome successfully. Wells syndrome is a rare eosinophilic disorder that primarily affects the skin. The rash consists of raised, red, swollen areas that may be warm to the touch. This means that eosinophilic cellulitis, or a subtype of eosinophilic cellulitis, affects less than 200,000 people in the us population. Wells syndrome ws, or eosinophilic cellulitis, is an uncommon. For language access assistance, contact the ncats public information officer. This report describes a rare case of eosinophilic cellulitis in association with angioimmunoblastic lymphadenopathy. Eosinophilic cellulitis wells syndrome is an inflammatory dermatitis that is often misdiagnosed as infectious cellulitis due to its similarity in presentation. Eight cases of eosinophilic cellulitis are described with acute cutaneous swellings followed by indolent infiltration. Wells syndrome eosinophilic cellulitis following vaccination. It is defined according to the following clinical and histological criteria. Wells syndrome is a rare disease which also goes by the name eosinophilic cellulitis. Not very many people are aware of this, but i have been diagnosed with eosinophilic cellulitis.
Ec is an idiopathic rare disorder representing wellcircumscribed erythematous plaques with variable appearances, for instances, papulovesicular, blistering. A 55yearold female patient presented with a skin biopsy verified. Treatment with dapsone was initiated at a dose of 50 mg per day. Eosinophilic cellulitis primary care dermatology society. Pdf eosinophilic cellulitis in a patient with gastric cancer.
Pdf eosinophilic cellulitis wells syndrome caused by. The rash comes on suddenly, lasts for a few weeks, and often repeatedly comes back. Wells syndrome, also known as eosinophilic cellulitis, is a rare condition that was first described in 1971 as a recurrent granulomatous dermatitis with eosinophilia. Successful treatment of eosinophilic cellulitis with dapsone. It is characterized by first edematous and later indurated plaques with eosinophilic infiltration of the dermis. Facial cellulitis of odontogenic origin may also occur.
Hiv, parasites, insect bites, erythema chronicum migrans autoimmune. Eosinophilic cellulitis wells eosinophilic cellulitis. Under treatment with oral prednisone andor a combination therapy with. It is an inflammatory reaction to some type of antigen that causes a reaction that mimics cellulitis. Wells syndrome, otherwise known as eosinophilic cellulitis, has an unknown etiology. Eosinophilic cellulitis is a rare condition first described in 1971 as recurrent granulomatous dermatitis with eosinophilia. Pdf on jun 6, 2018, sandra herout and others published eosinophilic cellulitis wells syndrome successfully treated with mepolizumab.
We report a case of recurrent cutaneous necrotizing eosinophilic vasculitis rcnev in a 57yearold male. Eosinophilic cellulitis wells syndrome in association. Apparently, the disease is incredibly rare fewer than 200 cases recorded in literature, and. The presentation usually involves a cellulitislike eruption, although papular, nodular and bullous eruptions have been reported. Less common but reported presentations also include nodules, vesicles, bullae, and urticaria. Group a strep streptococcal bacteria are the most common cause. We report a case of an 80yearold man with a longstanding diagnosis of stage iib mf who acutely developed parotid gland involvement and marked hypereosinophilia that most likely represented eosinophilic cellulitis. Cellulitis usually follows a break in the skin, such as a fissure, cut, laceration, insect bite, or puncture wound.
The histopathology shows degenerative collagen, histiocytes, and eosinophils. In people, the presentation usually involves a mildly pruritic or tender cellulitislike eruption with typical histologic features characterized by edema, flame figures, and a marked infiltrate of eosinophils in the dermis. It sometimes occurs as an exaggerated response to bites of spiders, bees, fleas, ticks, or mites arthropods, or it may have other causes such as surgery or drugs. Eosinophilic cellulitis is a very rare condition that was first described in 1971 by george wells. These bacteria live on the skin and may enter an area of broken skin like a cut or scratch and cause an infection in the tissue under the skin. Common imitators of cellulitis are stasis dermatitis, lipodermatosclerosis, contact dermatitis, lymphedema, eosinophilic celluli. Pdf eosinophilic cellulitis wells syndrome successfully treated.
Eosinophilic cellulitis wells syndrome is an uncommon inflammatory disease with clinical polymorphism. Also know as wells syndrome, the disease is technically an inflammation of skin cells and involves problems with the immune system and white blood cells. Eosinophilic cellulitis wells syndrome eosinophilic cellulitis wells syndrome fisher, george b greer, kenneth e cooper, philip h. The patches are usually bright red at first, frequently looking like cellulitis, then fade over four to eight weeks, leaving green, grey or brown patches. Wells syndrome in the dog vetgirl veterinary continuing. Eosinophilic cellulitis wells syndrome ws is a rare inflammatory skin disorder of unknown etiology. Eosinophilic cellulitis has been described as typically having 2 phases. Wells syndrome eosinophilic cellulitis is an acute, recurrent, pruritic dermatitis that is often described as a cellulitislike eruption with edema and eosinophils present in the dermis. Eosinophilic cellulitis wells syndrome eosinophilic cellulitis is a rare syndrome which may closely mimic bacterial cellulitis or bullous erysipelas. Eosinophilic cellulitis is listed as a rare disease by the office of rare diseases ord of the national institutes of health nih. Idiopathic bullous eosinophilic cellulitis wells syndrome responsive to topical tacrolimus and antihistamine combination prashant verma 1, archana singal 1, sonal sharma 2 1 department of dermatology and std, university college of medical sciences university of delhi and guru teg bahadur hospital, delhi university, delhi, india 2 department of pathology, university college of. Eosinophilic cellulitis, or wells syndrome, is a rare inflammatory dermatitis that involves a dermal infiltrate of eosinophils.
Eosinophilic cellulitis, also known as wells syndrome, is a skin disease that presents with painful, red, raised, and warm patches of skin. Cellulitis is an infection of the skin and deep underlying tissues. The patient had similar, milder prior episodes involving his hands and forearms that subsided without treatment. Pdf a 55yearold woman presented with a 3year history of recurrent episodes of pruritic cellulitislike erythematous plaques, mostly located. Eosinophilic cellulitis is thought to be precipitated by a number of triggering factors including drugs, arthropod bites, and viral infections. It was described for the first time by wells in 1971 as a recurring granulomatous dermatitis with eosinophilia, and was later named eosinophilic cellulitis. Fewer than 100 cases have been reported throughout the world.
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