Eosinophilic cellulitis (Wells’ syndrome) caused by a temporary henna tattoo

Nacaroğlu, Hikmet Tekin; Çeleğen, Mehmet; Karkıner, Canan Şule Ünsal; Günay, İlker; Diniz, Güllden; Can, Demet

doi:10.5114/pdia.2014.40951

Cited by 11 publications

(9 citation statements)

References 10 publications

(27 reference statements)

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“…Various pharmaceuticals are discussed as triggering factors, and an association with infections and paraneoplastic syndromes has also been described . In one case, patch testing was able to establish a correlation between Wells syndrome and contact sensitization to para‐phenylenediamine and thiomersal . Immune phenotyping has provided evidence for the involvement of CD3/CD4/CD25(+) respectively CD4(+)CD7(–) lymphocytes .…”

Section: Pathogenetic Aspectsmentioning

confidence: 99%

Wells syndrome

Weins

Biedermann

Weiss

et al. 2016

J Deutsche Derma Gesell

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Summary A rare eosinophilic dermatosis, Wells syndrome, also referred to as eosinophilic cellulitis, is characterized by great clinical variability. Typical findings include infiltrated erythematous plaques arising on the extremities. Lesions initially resemble erysipelas/cellulitis, however, they do not improve with antibiotic treatment. Eosinophilic cellulitis is a diagnosis of exclusion that may only be made over the course of the disease, taking into account clinical and characteristic histological findings (flame figures). Although multiple potential triggers have been proposed, the exact etiology remains unresolved. Involvement of abnormal Th2 cells, IL‐5, and activated eosinophilic granulocytes suggest a nonspecific hypersensitivity response to exogenous or endogenous stimuli. Corticosteroids may have a beneficial effect on the chronic, recurrent course frequently observed. The disease is often self‐limiting, healing without sequelae. Given that transitions to hematological and oncological disorders have been observed, patients should be closely followed up.

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Section: Pathogenetic Aspectsmentioning

confidence: 99%

Wells syndrome

Weins

Biedermann

Weiss

et al. 2016

J Deutsche Derma Gesell

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“…Sometimes, the localized eruption may become generalized and associated to systemic symptoms as fever and malaise [50, 51]. Exceptionally, a Sweet syndrome [52], Wells syndrome [53, 54], prurigo nodularis [55] and connubial contact dermatitis [56, 57] have been also described.…”

Section: Resultsmentioning

confidence: 99%

Hypersensitivity reactions due to black henna tattoos and their components: are the clinical pictures related to the immune pathomechanism?

et al. 2017

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Hypersensitivity to para-phenylenediamine (PPD) and related compounds induced by temporary black henna tattoos has become a serious health problem worldwide. Different patterns of sensitization with various clinical aspects are described in literature due to PPD associated to henna tattoo and these manifestations are likely correlated with the immunological and dermatological pathomechanisms involved. Henna is the Persian name of the plant Lawsonia inermis, Fam. Lythraceae. It is a woody shrub that grow in regions of North Africa, South Asia, India and Sri Lanka. Nowadays it is rather frequent to see temporary “tattoos” performed with henna. To make tattoos darker and long-lasting PPD has been associated to henna in tattoo drawings mixtures, so obtaining “black henna”. In these years there has been a rise of contact sensitization to PPD and in medical literature an increased number of cases have been reported on temporary henna tattoo application. Here we review the various clinical patterns related to PPD and henna tattoo, to investigate the possible link between clinic-morphological pictures and the immunological response to PPD and henna. The literature underlines that different clinical manifestations are related to black henna containing PPD, and its derivative products may cause delayed-type as well as immediate-type reactions. Further studies are needed to investigate the relationship between clinical and morphological aspects of PPD contact dermatitis and the T cell subsets predominance.

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“…Ebenso wurde ein Zusammenhang zu Infektionen und Paraneoplasien beschrieben . In einem Fall konnte mit Hilfe eines Epikutantests eine Kontaktsensibilisierung für Paraphenylendiamin und Thiomersal mit der Entwicklung eines Wells‐Syndroms in Verbindung gebracht werden . Mittels Immunphänotypisierung zeigte sich eine Beteiligung von CD3/CD4/CD25(+)‐ bzw.…”

Section: Pathogenetische Aspekteunclassified

Wells‐Syndrom

Weins

Biedermann

Weiss

et al. 2016

J Deutsche Derma Gesell

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Das Wells-Syndrom, auch als eosinophile Zellulitis bezeichnet, ist eine seltene, sporadisch auftretende eosinophile Dermatose mit polymorphem klinischem Bild. Als typisch gelten entzündliche Erytheme oder Plaques an den Extremitäten, die initial als Erysipel imponieren können, unter antimikrobieller Behandlung aber persistieren. Die eosinophile Zellulitis ist eine Ausschlussdiagnose, die in Zusammenschau von klinischem Befund und charakteristischem histologischem Bild (Flammenfiguren) nur im Verlauf gestellt werden kann. Mit einer Vielzahl möglicher Triggerfaktoren ist die Ätiologie nicht geklärt. Die Beteiligung abnormer Th2-Zellen, des Zytokins IL-5 und aktivierter eosinophiler Granulozyten lässt eine unspezifische Hypersensitivitätsreaktion auf exo- und endogene Stimuli vermuten. Die häufiger vorkommenden chronisch- rezidivierenden Formen lassen sich durch Glukokortikoide günstig beeinflussen. Der Verlauf ist meist selbstlimitierend, ohne Residuen. Aufgrund von Übergängen in hämatoonkologische Erkrankungen sind Verlaufskontrollen angezeigt.

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Eosinophilic cellulitis (Wells’ syndrome) caused by a temporary henna tattoo

Cited by 11 publications

References 10 publications

Wells syndrome

Wells syndrome

Hypersensitivity reactions due to black henna tattoos and their components: are the clinical pictures related to the immune pathomechanism?

Wells‐Syndrom

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