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The article describes the case of a 5-year-old boy who experienced Wells' syndrome associated with Mycoplasma pneumoniae. The patient had history of a pruritic, erythematous and edematous lesion on both ankles and feet. Laboratory investigations led to the diagnosis of M. pneumoniae infection. Gradual clinical improvement was observed after administration of oral clarithromycin and oral prednisolone.

The article discusses the various aspects of the dermatology related periodical "International Journal of Dermatology." It talks about the management of the skin diseases and the different updates it offers to the dermatologists worldwide. It discusses the various topics discussed in the issue including stigmata, dermatitis, and Wells syndrome.

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. [ABSTRACT FROM AUTHOR]

Abstract: A 4‐year‐old boy presented with erythematous vesicular plaques, ulceration, edema, and pruritus on the left foot and ankle 10 days after receiving the tetanus, diphtheria, pertussis, and polio; measles, mumps, rubella, and varicella; and hepatitis A/B vaccines. Biopsy showed eosinophilic infiltrates and flame figures, suggesting Wells syndrome. Patch testing showed a 1+ reaction to neomycin and aluminum hydroxide, with a recall reaction of Wells syndrome of the feet bilaterally. We report a rare case of pediatric Wells syndrome triggered by nonthimerosal vaccine components confirmed by patch testing. [ABSTRACT FROM AUTHOR]

A 10-week old preterm infant boy presented with a pustular eruption of the face and blood eosinophilia. Histology demonstrated eosinophils without predominant follicular involvement. The lesions healed without intervention within 2 months. The presentation was consistent with neonatal eosinophilic pustulosis. We discuss the similarities between cases described in the literature and suggest that this entity affects a unique patient population of preterm infants. [ABSTRACT FROM AUTHOR]

Background/Objective Eosinophilic annular erythema (EAE) was proposed to describe annular skin lesions associated with tissue eosinophilia, however, its relation to Well's syndrome (WS) remains a source of controversy. We studied a series of patients to increase awareness of this entity and to clarify its relation to WS. Methods A multicentre study in which the clinical records, histological findings, laboratory results, therapeutic responses and follow-up of 10 patients were demonstrated. Results The study included seven women and three men with age ranging from 31 to 54 years. The duration of the disease ranged from 3 to 28 months. All patients showed involvement of trunk and extremities. Early lesions were manifested as erythematous plaques, which progressed to well-developed figurate lesions and ended as large annular lesions with pigmented centre and elevated border. Flame figures were only observed in well-developed and long-standing lesions. Blood eosinophilia was found in all patients with different grades. Associated disorders included chronic gastritis, diabetes mellitus, chronic hepatitis-C virus infection and chronic kidney disease. The disease showed chronic course with high relapse rate and resistance to various therapeutic modalities including systemic steroid alone and in combination with hydroxychloroquine and cyclosporine. Conclusion We believe that EAE is a peculiar clinical variant in the spectrum of WS, which is characterized by a chronic course, resistance to treatment and high relapse rate. The diagnosis and evaluation of this condition need a close monitoring with repeated clinical, histological and laboratory assessment. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Chronic relapsing eosinophilic cellulitis associated, although independent in severity, with chronic lymphocytic leukemia," in the previous issue.

A 69-year-old woman with chronic lymphocytic leukaemia presented with an 18-month history of pruritic, tender, erythematous plaques. The recurrent lesions simulated insect bites and cellulitis, but failed to respond to appropriate treatments. A recent severe flare was associated with markedly elevated inflammatory markers and swelling of the left leg. The swelling settled rapidly with ibuprofen, leaving cellulitis around a small ulcer infected with Staphylococcus aureus and Streptococcus pyogenes. The cellulitis responded to oral flucloxacillin. Subsequent multiple small exaggerated insect bite reaction lesions settled with oral prednisolone. Eosinophilic cellulitis (Wells' syndrome) was considered unlikely based on the lack of a morphoea-like resolution phase, histological lack of flame figures and presence of vasculitis; however, the distinction is probably artificial. [ABSTRACT FROM AUTHOR]

Background Wells' syndrome was first described by Wells in 1971 as a recurrent granulomatous dermatitis with eosinophilia and was later named eosinophilic cellulitis. It is defined by the following criteria. (i) sudden onset of annular or circinate crythematous-edematous patches that rapidly evolve to morphea-like blue-state-colored plaques; (ii) a histological picture usually characterized by the presence of 'flame figures': (iii) non-constant blood hypereosinophilia. Methods We describe the case of a 49-year-old woman who reported the sudden appearance of a few hard, pasty, ovalshaped, reddish-violet, moderately itchy, erythematous-edematous patches on both arms about 2 months before our observation. Results The remote pathologic history showed that the woman have been submitted to quadrantectomy with lymph node dissection followed by cobalt therapy for breast cancer. Based on the pharmacological history intake of drugs was excluded. Routine blood chemistry and instrumental tests did not show any alteration, nor did assays of the main autoantibodies, complement, circulating immunocomplexes, or tumor markers. Conclusions Histologically the picture was compatible with the diagnosis of Eosinophilic cellulitis. Following topical corticosteroid therapy the lesion healed rapidly. It relapsed 2 months later, and was again cured with the same topical treatment. No further relapses were observed in a 1 year follow-up. [ABSTRACT FROM AUTHOR]

Wells' syndrome is a rare inflammatory dermatitis. To date, the cause is unknown but it has been associated with a variety of triggers. We present a case of Wells' syndrome with coexisting photosensitivity. [ABSTRACT FROM AUTHOR]

ABSTRACT We report a patient with Churg–Strauss syndrome (CSS) with asthma, eosinophilia, nasal polyposis and ANCA-associated multisystem vasculitis, who's skin eruption started with erythematous urticarial-plaques followed by haemorrhagic bullae. Histology of the plaques revealed ‘flame figures’ in the dermis with no granulomatous or vasculitic process, consistent with the diagnosis of eosinophilic cellulitis or Wells’ syndrome. The association of CSS and Wells’ syndrome observed in this patient may have a common pathogenesis. CSS may induce Wells’ syndrome by an unknown factor. [ABSTRACT FROM AUTHOR]

The article discusses the n inflammatory dermatosis called Wells syndrome. It talks about the histopathological findings of the disease. It discusses Neutrophils occurring in the ailment. It discusses the use of omalizumab and corticosteroids in the treatment. It discusses the decreasing cytokines contributing to the treatment.

Eosinophilic cellulitis in a 56 year old woman is described. The patient responded well to oral prednisolone, but attempts to withdraw the corticosteroid resulted in relapses. Remission was achieved with a combination of dapsone, antihistamine and alternate-day prednisolone. [ABSTRACT FROM AUTHOR]

The article describes the case of a 56-year-old man who had a one-year history of recurrent episodes of pruritic papular and vesicobullous lesions. The patient received a regimen of oral prednisolone, topical steroids and antibiotics, which resulted in significant improvement in his condition. He was diagnosed with eosinophilic dermatosis associated with hematological disorders similar to Wells syndrome (WS).

Eosinophilic cellulitis, or Wells syndrome, is a rare but well-described condition in which bullous lesions are uncommon, especially in childhood. We report a case of bullous eosinophilic cellulitis recalcitrant to steroid therapy in a 9-year-old boy who was successfully treated with oral dapsone. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 51-year-old woman who was presented with a shortness of breath and bronchial asthma. Severa; erythematous, indurated, urticarial plaques were discovered at the chest, abdomen and upper extremeties of the patient. Skin biopsy revealed marked edema in the upper dermis. The article discusses the connection between Wells' syndrome and Chug-Strauss syndrome.