Eosinophilic cellulitis

Other names| Wells' syndrome, recurrent granulomatous dermatitis with eosinophilia[1]
Initial rash in eosinophilic cellulitis
Specialty| Dermatology
Symptoms| Painful, red, raised, warm patches of skin, fever, joint pain[2]
Usual onset| Sudden and recurrent[2]
Duration| Few weeks[2]
Causes| Unknown[2]
Differential diagnosis| Vasculitis, cellulitis, anaphylaxis[2][1]
Medication| Corticosteroids, antihistamines[2][1]
Prognosis| Often goes away by itself[2]
Frequency| ~200 documented cases[1]

Eosinophilic cellulitis, also known as Wells' syndrome (not to be confused with Weil's disease), is a skin disease that presents with painful, red, raised, and warm patches of skin.[2] The rash comes on suddenly, lasts for a few weeks, and often repeatedly comes back.[2] Scar formation does not typically occur.[1]

Eosinophilic cellulitis is of unknown cause.[2] It is suspected to be an autoimmune disorder.[2] It may be triggered by bites from insects and arachnids such as spiders, fleas, or ticks, or from medications or surgery.[2] Diagnosis is made after other potential cases are ruled out.[1] Skin biopsy of the affected areas may show an increased number of eosinophils.[2] Other conditions that may appear similar include cellulitis, contact dermatitis, and severe allergic reactions such as anaphylaxis.[2]

Treatment is often with a corticosteroids.[2] Steroids applied as a cream is generally recommended over the use of steroids by mouth.[3] Antihistamines may be used to help with itchiness.[1] Many times the condition goes away after a few weeks without treatment.[2] The condition is uncommon.[1] It affects both sexes with the same frequency.[2] It was first described by George Crichton Wells in 1971.[1][4]

## Contents

* 1 Cause
* 2 Diagnosis
* 3 Treatment
* 4 References
* 5 External links

## Cause

Eosinophilic cellulitis is of unknown cause.[2] It is suspected to be an autoimmune disorder.[2] It may be triggered by bites from insects such as mosquitos,[5] spiders, fleas, or ticks, or from medications or surgery.[2]

## Diagnosis

Histology of a skin biopsy from acute phase eosinophilic cellulitis. Note findings of plentiful tissue eosinophils and flame figures at the deeper corium sections (hematoxylin & eosin, original magnification ×40).

Diagnosis requires ruling out other potential causes.[1] This includes ruling out vasculitis on skin biopsy.[1]

## Treatment

Treatment is often with a steroids.[2] This can be either applied as a cream or taken by mouth.[3] As the condition tends to get better on its own taking steroids by mouth should generally only be tried if the rash covers a large area and it does not get better with other measures.[3]

## References

1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 Weins, AB; Biedermann, T; Weiss, T; Weiss, JM (October 2016). "Wells syndrome.". Journal der Deutschen Dermatologischen Gesellschaft 14 (10): 989–993. doi:10.1111/ddg.13132. PMID 27767278.
2. ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 "Familial Eosinophilic Cellulitis - NORD (National Organization for Rare Disorders)". 2009. http://rarediseases.org/rare-diseases/familial-eosinophilic-cellulitis/.
3. ↑ 3.0 3.1 3.2 Räßler, F; Lukács, J; Elsner, P (September 2016). "Treatment of eosinophilic cellulitis (Wells syndrome) - a systematic review.". Journal of the European Academy of Dermatology and Venereology 30 (9): 1465–79. doi:10.1111/jdv.13706. PMID 27357601.
4. ↑ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
5. ↑ "Clinical categories of exaggerated skin reactions to mosquito bites and their pathophysiology". Journal of Dermatological Science 82 (3): 145–52. June 2016. doi:10.1016/j.jdermsci.2016.04.010. PMID 27177994.

## External links

Classification|

* ICD-10: L98.3 (ILDS L98.300)
* DiseasesDB: 34888

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* DermNet NZ entry

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