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

Abstract

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.

Painful Nodules on an Infant's Feet

“…As in our case, arthropod bites are the most frequently reported precipitating factor—as a trigger or as an exacerbating factor . Other triggers include bacterial, parasitic, and fungal infections; vaccinations; myeloproliferative disorders; as well as various medications.…”

“…Other triggers include bacterial, parasitic, and fungal infections; vaccinations; myeloproliferative disorders; as well as various medications. In about half of reported pediatric cases, no identifiable trigger could be found . The mechanism of lesion seems to be a hypersensitivity reaction to arthropod antigens.…”

“…The syndrome is seen more commonly in adults than in children . Recently, Farina et al reviewed 45 pediatric cases of Wells syndrome reported in the literature since 1979. The average age of onset was 5 years, with a slight male predominance (1.6:1).…”