Wells' syndrome. Recurrent granulomatous dermatitis with eosinophilia

Spigel, G. Thomas

doi:10.1001/archderm.115.5.611

Cited by 51 publications

(37 citation statements)

References 2 publications

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“…Usually the skin returns to normal without any scarring. 2 The condition may occur on different locations, preferably the extremities, trunk and the face area. 3 The clinical appearance may vary, and the lesions modify during their life cycle.…”

Section: Introductionmentioning

confidence: 99%

Treatment of eosinophilic cellulitis (Wells syndrome) – a systematic review

Räßler

Lukács

Elsner

2016

Acad Dermatol Venereol

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Eosinophilic cellulitis (Wells syndrome) is a rare inflammatory skin disease defined by erythematous, tender, sometimes urticarial plaques, possibly with vesicles and bullae, and granulomatous eosinophilic infiltrates in the dermis. Usually the disease has a benign course with spontaneous remission within a few weeks. Nevertheless, recurrences are quite frequent and may occur for several years. The objective of this study was to review the so far reported treatment options for Wells syndrome in a systematic manner. This systematic review is based on a search on Medline, Embase and Cochrane Central Register for English and German articles from 1970 to 2015. Advices on the treatment of Wells syndrome are limited predominately to case reports or to small case series. There are no randomized controlled trials, and control groups are missing. A variety of treatment options for Wells syndrome were reported including topical and systemic corticosteroids, antihistamines, cyclosporine, dapsone, azathioprine, griseofulvin, doxycycline, minocycline, antimalarial medications, oral tacrolimus/topical tacrolimus, sulfasalazine, interferon alpha and gamma, TNF alpha inhibitors, colchicine and PUVA therapy. As well-designed, randomized controlled trials are missing, no guidelines for the treatment of this disease can be given. Due to the small number of patients and the frequent misdiagnosis of this clinical entity, the aim of this systematic overview is to call attention to this rare condition and to help clinicians to diagnose and treat Wells syndrome effectively. Due to the good prognosis and tendency to resolve, systemic treatment should be limited to cases resistant to local therapy or with widespread lesions.

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Section: Introductionmentioning

confidence: 99%

Treatment of eosinophilic cellulitis (Wells syndrome) – a systematic review

Räßler

Lukács

Elsner

2016

Acad Dermatol Venereol

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“…ELLS SYNDROME, 1 OR eosinophilic cellulitis, first described by Wells in 1971 as recurrent granulomatous dermatitis with eosinophilia, 2 is an uncommon inflammatory dermatosis of uncertain pathogenesis characterized by clinical polymorphism, suggestive but nonspecific histopathologic traits, usually a recurrent course, and inconstant response to therapy.…”

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confidence: 99%

Wells Syndrome in Adults and Children

Caputo¹,

Marzano²,

Vezzoli³

et al. 2006

Arch Dermatol

108

115

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“…Our cases support this view, since a parasitic infection {Onchocerca volvulus) was found. Direct immunofluorescence studies reveal (as far as performed so far) a pattern suggestive of vasculitis (Spigel & Winkelmann, 1979). We too feel this syndrome is not a disease entity but a reaction pattern.…”

Section: Discussionmentioning

confidence: 62%

Eosinophilic cellulitis as a result of onchocerciasis

Hoogenband

1983

Clin Exp Dermatol

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Two typical cases of eosinophilic cellulitis (Well's syndrome) are described. In both cases there is strong evidence that it must be regarded as a reaction to onchocerciasis.The syndrome is probably always due to certain stimuli, e.g. parasitic infections.Wells (1971) reported on four cases, showing a clinical picture of periodic severe swellings before or after which there were undiagnostic cutaneous symptoms. The histopathology was characteristic showing infiltration of leucocytes (predominantly eosinophils) and 'flame figures' consisting of collagen covered by eosinophilic material, either amorphous or granular, surrounded by histiocytes and macrophages. Wells & Smith (1979) published data on eight additional cases. Furthermore the characteristic histological pattern was seen in the course of other dermatoses, e.g. pemphigoid, herpes gestationis and tinea in nine patients. They proposed the name 'eosinophilic cellulitis' for the syndrome. In some of their patients an underlying or concomitant disorder could be demonstrated like previous administration of drugs, mycosis and insect bites. Also parasitic infections were thought of, but could never be demonstrated.Recently we had the opportunity to study two patients who suffered from eosinophilic cellulitis and onchocerciasis simultaneously. Case reports Case IA 42-year-old male presented with a pruritic papular eruption on the right arm and shoulder of 3 months' duration. The eruption then gradually extended on the trunk and became more

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Wells' syndrome. Recurrent granulomatous dermatitis with eosinophilia

Cited by 51 publications

References 2 publications

Treatment of eosinophilic cellulitis (Wells syndrome) – a systematic review

Treatment of eosinophilic cellulitis (Wells syndrome) – a systematic review

Wells Syndrome in Adults and Children

Eosinophilic cellulitis as a result of onchocerciasis

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