Wells syndrome in a child triggered by parvovirus B19 infection?

Barreiros, Hugo; Matos, Diogo; Furtado, Constança; Cunha, Henriqueta; Bártolo, Elvira

doi:10.1016/j.jaad.2012.01.012

Cited by 11 publications

(3 citation statements)

References 5 publications

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“…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.…”

Section: Discussionmentioning

confidence: 98%

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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Section: Discussionmentioning

confidence: 98%

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

Farina¹

2014

CDERM

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“…Wells as "recurrent granulomatous dermatitis with eosinophilia" [55], WS is a rare dermatosis without ethnic or gender predilection that primarily affects adults [56]. The etiology is unknown, although some cases have been associated with various underlying conditions and triggers, including hematologic disorders [20,[57][58][59][60][61][62][63][64][65], hypersensitivity reaction to insect bites [40,66,67], medications [68][69][70], infections [71][72][73], and vaccinations [56,[74][75][76]. Peripheral eosinophilia, leukocytosis, or elevated inflammatory markers may be observed [58,77].…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic Dermatosis of Hematologic Malignancy: Emerging Evidence for the Role of Insect Bites—A Retrospective Clinico-Pathological Study of 35 Cases

Michelerio,

Rubatto,

Roccuzzo

et al. 2024

JCM

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Background/Objectives: Eosinophilic dermatosis of hematologic malignancy (EDHM) is a rare cutaneous disorder associated with various hematologic malignancies, most commonly chronic lymphocytic leukemia. Detailed clinicopathologic studies of EDHM are lacking and the pathogenesis remains enigmatic. Initially thought to be a hypersensitivity reaction to insect stings, subsequent reports have challenged this understanding. The prognostic implications of EDHM remain unclear. Methods: A retrospective clinicopathologic study was performed on patients diagnosed with EDHM. Hematologic and dermatologic data were reviewed. Histologic specimens were re-evaluated and lesions were classified into acute/subacute, fully developed, and chronic/regressing. Results: The study included 35 patients. In 80% of these patients, EDHM was diagnosed after the hematologic disorder. Approximately 45% of the cohort experienced hematologic disease progression or relapse, while 65% required therapeutic intervention during the course of their hematologic disease. In total, 15/19 CLL patients had non-mutated IgHV, a marker of a more aggressive hematologic disease course. Dermatologic lesion morphology was heterogeneous, with most lesions occurring on exposed areas, and a significant 94% of patients demonstrated lesion seasonality. Histopathologic findings were consistent with features typically associated with insect bites. In addition, examination of lesions at different chronological stages revealed substantial similarities with Wells syndrome. Conclusions: Our findings support the potential role of insect bites in triggering EDHM in the context of adaptive immune dysfunction. EDHM may be associated with a more aggressive disease course or may be a marker of disease progression. The observed co-occurrence of features typical of Wells syndrome in EDHM patients suggests that these conditions are part of a spectrum of disorders that vary in clinical expression.

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“…Pathological aetiologies have yet to be clarified, but insect bites, parasitic infections, and drugs have been implicated as trigger factors (2)(3)(4)(5)(6). Viral agents, such as human parvovirus B19, herpes simplex virus, and even influenza virus vaccination, have also been reported to trigger Wells' syndrome (7)(8)(9).…”

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confidence: 99%