Wells’ Syndrome Associated with Parvovirus in a 5‐Year Old Boy

Abstract

Wells' syndrome, otherwise known as eosinophilic cellulitis, is a rare dermatosis seen more commonly in adults than in children. In this article, we present a 5-year-old Caucasian boy who initially presented with pruritic, erythematous macules and papules evolving to bullae formation. Subsequent histology confirmed diagnosis of Wells' syndrome, and additional blood work also demonstrated positive immunoglobulin (Ig)M and IgG for parvovirus. In many instances, the direct etiology of Wells' syndrome is unclear, but the link between parvoviral infection and development of Wells' syndrome could further support an additional cause.

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

“…The histopathologic findings are characterized by flame figures, which are composed of eosinophil major basic protein deposited on collagen bundles that was found in our case but was not specific [3, 7–10]. The papulonodular form, a rare form of Wells’ syndrome, is considered with clinical and histological findings in our case.…”

Cellulitis-Like Lesions: An Unusual Manifestation of a Parvovirus B19 Infection

“…Wells syndrome, an eosinophilic cellulitis characterized by erythematous plaques and edema of the skin, resembles bacterial cellulitis with minor systemic symptoms, but there are typical histopathologic features, with the dermis and hypodermis massively infiltrated by eosinophils. 4 In our case, the typical skin lesions of fifth disease were associated, especially on the lower leg, with persistent swelling in otherwise-healthy patients; the swelling and pain started during the disappearance of the reticular macular rash, remained a few weeks and finally resolved spontaneously. n Figure. A and B, Swelling with a cellulitis-like appearance localized bilaterally on the lower leg.…”

Wells� syndrome in childhood: two case reports with review of the literature

“…Blood eosinophilia could be found in more than 50% of the cases (29 of 45 cases; 64%); in these patients, the level of eosinophils fluctuates with the course of the disease, returning to reference range on clinical remission. In only seven cases bullous lesions were present (7,(12)(13)(14)(15)(16). The extremities are most frequently affected, but truncal involvement is also observed.…”

“…There are also several reports of Wells' syndrome associated with bacterial, parasitic, and fungal infections (7). To our knowledge only 3 reports associate Wells' syndrome to parvovirus B19 as a potential trigger factor (12,17,18). Numerous medications have been implicated as triggers for adult Wells' syndrome.…”