Wells' syndrome (eosinophilic cellulitis): correlation between clinical activity, eosinophil levels, eosinophil cation protein and interleukin-5

España, A.; Ml, Sánz; Sola, Josu; P, Gil

doi:10.1046/j.1365-2133.1999.02621.x

Cited by 83 publications

(52 citation statements)

References 20 publications

(20 reference statements)

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“…Increased interleukin-5 levels have been observed, which mobilizes eosinophils from the bone marrow and facilitates their homing to the skin (12)(13)(14). Interleukin (lL)-5 also increases CD25, part of the lL-2 receptor, which promotes degranulation of the eosinophils.…”

Section: Discussionmentioning

confidence: 96%

Eosinophilic Cellulitis (Wells’ Syndrome) in Association with Angioimmunoblastic Lymphadenopathy

Renner¹,

Kauer²,

Treudler³

et al. 2007

Acta Derm Venereol

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Eosinophilic cellulitis (Wells' syndrome) is an uncommon inflammatory disease with clinical polymorphism. It is often associated with infectious, allergic or myeloproliferative diseases; however, the exact aetiology is unknown. This report describes a rare case of eosinophilic cellulitis in association with angioimmunoblastic lymphadenopathy. The typical skin findings of Wells' syndrome disappeared completely following chemotherapy and autologous stem cell transplantation.

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Section: Discussionmentioning

confidence: 96%

Eosinophilic Cellulitis (Wells’ Syndrome) in Association with Angioimmunoblastic Lymphadenopathy

Renner¹,

Kauer²,

Treudler³

et al. 2007

Acta Derm Venereol

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“…Increased IL-5 levels have been detected in Wells' syndrome, and IL-5 not only mobilizes eosinophils from the bone marrow but also promotes homing of eosinophils by altering expression of adhesion molecules. In addition, increased levels of IL-5 appear to induce expression of CD25, the α chain of the IL-2 receptor, which enhances eosinophil degranulation and subsequent tissue damage (23)(24)(25) …”

Section: Discussionmentioning

confidence: 99%

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

Farina¹

2014

CDERM

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SummaryWells' syndrome, or eosinophilic cellulitis, is a rare disorder manifesting with acute erythematous and edematous plaques which resolve completely. Bullous lesions are uncommon, especially in childhood. We present two pediatric cases of bullous Wells' syndrome, one 3-year-old boy with atypical cutaneous manifestations and one 6-month-old girl with typical skin lesions. No trigger factors could be identified in both cases. Treatment with topical and systemic steroids was performed. Both patients had no recurrences after two years. Fortyfive pediatric cases of Wells' syndrome have been reported in the literature with an average age of onset of five years. In only seven cases bullous lesions were present. In about half of the patients a precipitating factor has been identified, including infections, arthropod bites, drug administration and hematologic disorders.

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“…In addition, increased levels of IL-5 appear to induce expression of CD25, the ␣ chain of the IL-2 receptor, which enhances eosinophil degranulation and subsequent tissue destruction. [46][47][48] Treatment for Wells' syndrome is sometimes unnecessary, because cases often resolve spontaneously. If an infection or other treatable precipitating factor can be identified, then there is often improvement with treatment of the underlying condition.…”

Section: Discussionmentioning

confidence: 99%

Bullous “Cellulitis” With Eosinophilia: Case Report and Review of Wells' Syndrome in Childhood

Gilliam¹,

Bruckner

Howard³

et al. 2005

Pediatrics

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ABSTRACT. A 1-year-old girl presented with acute onset of edematous erythematous plaques associated with bullae on her extremities and accompanied by peripheral eosinophilia. She was afebrile, and the skin lesions were pruritic but not tender. The patient was treated with intravenously administered antibiotics for presumed cellulitis, without improvement. However, the lesions responded rapidly to systemic steroid therapy. On the basis of lesional morphologic features, peripheral eosinophilia, and cutaneous histopathologic features, a diagnosis of Wells' syndrome was made. Wells' syndrome is extremely rare in childhood, with 27 pediatric cases reported in the literature. Because it is seen so infrequently, there are no specific guidelines for evaluation and management of Wells' syndrome among children. W ells' syndrome, or eosinophilic cellulitis, is a rare, recurrent, inflammatory dermatosis of unknown pathogenesis. In 1971, Wells 1 described 4 patients with an acute pruritic dermatitis clinically resembling bacterial cellulitis but with histopathologic findings characterized by dermal eosinophilia, phagocytic histiocytes, and the presence of flame figures. He initially called this syndrome recurrent granulomatous dermatitis with eosinophilia but later simplified the name to eosinophilic cellulitis. 2 Wells' syndrome is seen more commonly among adults but has been observed among children. Some hypothesize that this syndrome may represent a hypersensitivity response to a circulating antigen. 2 Associated precipitants include insect bites, medication reactions, recent immunization, myeloproliferative disorders, malignancies, and infections. We describe a case of a young child with no identifiable triggering factors, and we review the evidence for evaluation and management of these pediatric cases. CASE REPORTA previously healthy, 1-year-old girl presented with acute onset of edematous erythematous plaques, with associated bullae, on her lower extremities and left arm (Fig 1). These lesions were pruritic but not painful, and the patient was afebrile. Her parents denied a history of insect bites, ingestion of medications, trauma, or other intercurrent illness. The patient's most recent immunizations had been received 3 months earlier. The patient did not have a history of asthma, and there was no family history of asthma or atopic disease.The patient was admitted with presumed bacterial cellulitis and was treated with intravenously administered oxacillin, without improvement. Her laboratory studies were significant for an elevated white blood cell count of 30 ϫ 10 9 cells per L, with peripheral eosinophilia of 48%. After the patient failed to respond to systemically administered antibiotics, examination of vesicle fluid was performed and revealed numerous eosinophils. Subsequently, the diagnosis of probable Wells' syndrome was made. Oral steroid therapy was started at 2 mg/kg, and the patient's cutaneous symptoms improved within 24 hours, leaving residual erythema and hyperpigmentation (Fig 2). Five days after the i...

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Wells' syndrome (eosinophilic cellulitis): correlation between clinical activity, eosinophil levels, eosinophil cation protein and interleukin-5

Cited by 83 publications

References 20 publications

Eosinophilic Cellulitis (Wells’ Syndrome) in Association with Angioimmunoblastic Lymphadenopathy

Eosinophilic Cellulitis (Wells’ Syndrome) in Association with Angioimmunoblastic Lymphadenopathy

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

Bullous “Cellulitis” With Eosinophilia: Case Report and Review of Wells' Syndrome in Childhood

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