A patient with Wells’ syndrome

Ladoyanni, Evmorfia; Vlachou, C.; Thushara, R.; Snead, David

doi:10.1111/j.1365-2230.2008.03132.x

Cited by 8 publications

(15 citation statements)

References 4 publications

(4 reference statements)

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“…The pathogenesis of Wells syndrome is still unknown. It seems to present a hypersensitivity reaction to a number of stimuli which may include insect bites, medications, infections, vaccinations, malignant tumours and myeloproliferative disorders . There is a controversy whether Wells syndrome is a distinctive clinical entity or just a histopathological reaction pattern in diseases related with hypereosinophilia .…”

Section: Introductionmentioning

confidence: 99%

Treatment of eosinophilic cellulitis (Wells syndrome) – a systematic review

Räßler

Lukács

Elsner

2016

Acad Dermatol Venereol

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Eosinophilic cellulitis (Wells syndrome) is a rare inflammatory skin disease defined by erythematous, tender, sometimes urticarial plaques, possibly with vesicles and bullae, and granulomatous eosinophilic infiltrates in the dermis. Usually the disease has a benign course with spontaneous remission within a few weeks. Nevertheless, recurrences are quite frequent and may occur for several years. The objective of this study was to review the so far reported treatment options for Wells syndrome in a systematic manner. This systematic review is based on a search on Medline, Embase and Cochrane Central Register for English and German articles from 1970 to 2015. Advices on the treatment of Wells syndrome are limited predominately to case reports or to small case series. There are no randomized controlled trials, and control groups are missing. A variety of treatment options for Wells syndrome were reported including topical and systemic corticosteroids, antihistamines, cyclosporine, dapsone, azathioprine, griseofulvin, doxycycline, minocycline, antimalarial medications, oral tacrolimus/topical tacrolimus, sulfasalazine, interferon alpha and gamma, TNF alpha inhibitors, colchicine and PUVA therapy. As well-designed, randomized controlled trials are missing, no guidelines for the treatment of this disease can be given. Due to the small number of patients and the frequent misdiagnosis of this clinical entity, the aim of this systematic overview is to call attention to this rare condition and to help clinicians to diagnose and treat Wells syndrome effectively. Due to the good prognosis and tendency to resolve, systemic treatment should be limited to cases resistant to local therapy or with widespread lesions.

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Section: Introductionmentioning

confidence: 99%

Treatment of eosinophilic cellulitis (Wells syndrome) – a systematic review

Räßler

Lukács

Elsner

2016

Acad Dermatol Venereol

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“…Clinical evolution in EC is paralleled by histological changes and correlated with the immunobiology of eosinophils, not only in blood but in bone marrow and tissues 2,3,5,9. During the acute stage, there is marked dermal edema and a predominantly eosinophilic infiltrate in the upper and mid epidermis without signs of vasculitis 3.…”

Section: Discussionmentioning

confidence: 94%

“…During the acute stage, there is marked dermal edema and a predominantly eosinophilic infiltrate in the upper and mid epidermis without signs of vasculitis 3. If edema is pronounced, the epidermis may be spongiotic, and subepidermal bullae may develop.…”

Section: Discussionmentioning

confidence: 99%

“…The site and appearance of cutaneous lesions vary, but they usually affect the extremities 2. Treatment consists of systemic or topical corticosteroid or cyclosporine, but patients with EC show variable responses 2,3,5. We describe here an 11-year-old girl with EC who showed a good response to steroid treatment but developed side effects and relapsed as steroids were tapered, but was then successfully treated with cyclosporine.…”

Section: Introductionmentioning

confidence: 99%

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Successful Treatment of Steroid-Dependent Eosinophilic Cellulitis With Cyclosporine

Kim

Kwon

Kim

2013

Allergy Asthma Immunol Res

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Eosinophilic cellulitis (EC) is a rare idiopathic disorder, first described as a "recurrent granulomatous dermatitis with eosinophilia", that mimics cellulitis of infectious origin. We describe here a previously healthy 11-year-old girl who experienced fever and tender erythematous patch lesions after trauma to her knees. Because of the relapsing cellulitis-like skin lesions, skin biopsies were taken, resulting in a diagnosis of EC. The patient responded well to oral prednisolone but experienced side effects and relapse during dose tapering. She was switched from prednisolone to cyclosporine. Her EC remained under control, and she showed no evidence of relapse after discontinuation of cyclosporine.

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“…This cytokine is responsible for differentiation and mobilization of eosinophils and for expression of associated adhesion molecules. Eosinophil cationic protein is one of the toxic cationic proteins contained in eosinophils granules, which mediates tissue damage . In WS, high levels of eosinophil cationic protein and IL‐5 have been found in peripheral blood and skin.…”

Section: Discussionmentioning

confidence: 99%