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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]

Eosinophilic cellulitis (Wells' syndrome) is an uncommon condition of unknown etiology. Wells' syndrome is usually seen in adulthood but very rare in childhood. Although pathogenesis of the disease is not very clear, it is a hypersensitivity reaction developing against a variety of exogenous and endogenous antigenic stimuli. Paraphenylenediamine is a strong allergen frequently used as a temporary henna tattoo, which makes the color darker . Here, a 9-year-old male patient with Wells' syndrome is presented, which developed following a temporary henna tattoo and shown by the patch test sensitivity to paraphenylenediamine. [ABSTRACT FROM AUTHOR]

Abstract: Perivascular epithelioid tumors (PEComa) are uncommon mesenchymal neoplasms demonstrating positivity for muscular and melanocytic immuno-markers. Included in this category are angiomyolipoma, lymphangioleiomyomatosis, and clear cell sugar tumors. Lesions which do not fit into these categories are classified as “not otherwise specified”. We present a case of an incidentally discovered PEComa within inguinal hernia sac contents in a 70-year-old woman. It consisted of spindled and epithelioid cells with bland oval nuclei, small nucleoli and clear to light eosinophilic cytoplasm. There was no atypia or mitoses. The lesion was strongly positive for HMB45 and smooth muscle actin. Pelvic soft tissue and peritoneal PEComas are rarely reported in literature and very little is known about their prognosis. We discuss the immunohistochemistry, differential diagnosis, and pathogenesis of PEComas. [Copyright &y& Elsevier]

Wells syndrome or eosinophilic cellulitis is a rare condition, primarily a disease of adults. It is characterized by edematous and erythematous plaques with violaceous borders persisting for weeks. Here, we describe a rare case of Wells syndrome occurring in a 51-year-old diabetic lady associated with a dental abscess. She was admitted with complaints of recurrent episodes of raised skin lesions on the body for the last two years. Patient also gave history of toothache with swelling of gums on and off since the last 2 years A skin biopsy was done from a raised lesion on the back which was consistent with eosinophilic cellulitis The patient was put on prednisolone 40mg daily along with ranitidine, calcium and oral hypoglycemics. She underwent tooth extraction for recurrent dental abscesses in the dental OPD. Our patient had dental abscess, a known predisposing factor. The association with diabetes mellitus is another unique feature, rarely reported before. [ABSTRACT FROM AUTHOR]

Wells syndrome is an inflammatory eosinophilic dermatosis of unknown pathogenesis characterized by clinical polymorphism, a suggestive but nonspecific histopathologic traits, usually with a recurrent course and inconstant response to therapy. It seems to be an unspecific hypersensitivity reaction in response to various exogenous and endogenous stimuli, such as insect bites, infections, drug eruption or underlying internal disorders. We present a patient with allergic asthma and atopic dermatitis in whom a skin eruption developed in the sequence of allergic asthma exacerbation, which was clinically and histologically consistent with the diagnosis of eosinophilic cellulitis. The authors discuss the probability of a common pathogenesis and the role of IL-5. To our best knowledge this is the first pediatric case where this association is reported. [ABSTRACT FROM AUTHOR]

Wells' syndrome is a multifaceted dermatosis with a wide morphological spectrum, ranging from characteristic cellulitis-like erythema and papula to an unusual presentation of vesicles and pustules. The most important elements for diagnosis are erythemal plaques and histological picture of eosinophilic infiltration of the dermis with 'flame figures' (Plotz et al., in Hautarzt 51:182-186, ). Because of its original description as a distinct entity, it has come to be regarded as an abnormal eosinophilic response to a number of causative agents such as herpes simplex virus 2(HSV-2) and toxocara (Ludwig et al., in J Am Acad Dermatol 48:S60-S61, ; Bassukas et al., in Cases J 1:356, ). Concurrence of WS and malignant diseases as colon cancer, trachea squamous carcinoma, nasopharyngeal carcinoma or angioimmunoblastic lymphadenopathy has been reported (Hirsch et al., in J Dtsch Dermatol Ges 3:530-531, ; Renner et al., in Acta Derm Venereol 87:525-528, ). Autoimmune diseases, including Systemic lupus erythematosus (SLE) are multi-system disorders of unknown cause and are commonly characterized by protean cutaneous manifestations. To date, few autoimmne disease was found associated with WS except four previous reports of Churg-Strauss syndrome (CSS) and one case of ulcerative colitis (Fujimoto et al., in Clin Exp Dermatol, ; Sakaria et al., in J Gastroenterol 42:250-252, ). The coexistence of SLE and WS in one patient was not found in literature and our case is the first. Here we described the rare combination and discussed the treatment strategy for this condition. [ABSTRACT FROM AUTHOR]

Stings by honeybees are not uncommon and most cases cause pain but no significant medical problems. Some patients, however, have lethal complications such as acute anaphylactic shock. Cellulitis caused by honeybee sting is very rare and can be a late complication in some patients. We report a 45-year-old female patient who was stung by a honeybee, and whose right forearm showed progressive swelling with bullous formation after the sting. She was sent to our emergency department with the diagnosis of right hand cellulitis. After treatment with antibiotics for 5 days, the lesions showed no response. Then, systemic steroid was used and the lesion gradually resolved. Diagnosis of Wells'' syndrome was made according to clinical appearance, course and characteristic histopathological findings. [Copyright &y& Elsevier]

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]

Wells' syndrome, also termed eosinophilic cellulitis, is a dermatologic condition of unknown etiology that occurs as recurrent patches or plaques mimicking infectious cellulitis. Histopathology reveals an eosinophilic infiltrate and characteristic flame figures. Previous reports have associated this syndrome with parasitic infections, arthropod bites, pharmacologic agents, surgery, and hematologic disorders. We present a case report of a patient with Wells' syndrome associated with newly diagnosed ulcerative colitis. The dermatosis erupted concurrently with flares of ulcerative colitis. Furthermore, treatment of the ulcerative colitis led to resolution of the skin lesions. To our knowledge this describes the first association between inflammatory bowel disease and Wells' syndrome and argues for a distinct relationship between the two. [ABSTRACT FROM AUTHOR]

Wells' syndrome is a multifaceted dermatosis with a wide morphological spectrum, ranging from characteristic cellulitis-like erythema and wheals to an unusual presentation of vesicles and bullae. We describe a patient in whom Wells' syndrome presented as an insect-bite-like eruption and was associated with underlying mantle-cell lymphoma. We recommend meticulous investigation of patients diagnosed with Wells' syndrome manifesting as an insect-bite-like eruption. [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]

Wells’ syndrome (WS) is a rare, recurrent, inflammatory dermatosis of uncertain pathogenesis, although a hypersensitivity response to different stimuli has been postulated. Several cases in association with parasitic infections have been described. We present a patient with WS associated with recurrent giardiasis. The course of the dermatosis was strictly related to the course of the parasitic infection. Both diseases disappeared with antiparasitic treatment. To our knowledge, this association is here reported for the first time. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 45-year-old man with a history of fever and erythema of the extremities, the presence of lymphocytes and eosinophils were detected. It notes the demonstration of blood neutrophilia and the increased C-reactive protein, the impact of coxsackievirus A6 infection, and diagnosis of the patient for Wells' syndrome.

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.

The article focuses on Splendore–Hoeppli phenomenon. It includes information on eosinophilic material in Splendore–Hoeppli reaction, inflammatory reaction of histiocytes, epithelioid cells, and giant cells. It also offers information on topics including Well's syndrome, actinomycotic sulfur granules, and asteroid bodies in sarcoidosis.

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]

Eosinophilic cellulitis (EC), also known as Wells syndrome, is a rare idiopathic, painful or pruritic, non-infectious type of cellulitis of unknown pathogenesis. EC usually presents as indurated plaques resembling infectious cellulitis, sometimes with blisters, usually resolving in several days or weeks, often with peripheral eosinophilia. Although most cases of EC are idiopathic, some are associated with arthropod bites, parasitic infection (such as giardiasis and toxocariasis), drug allergy, and internal malignancy. Here we report an unusual case of a 71-year-old man with a history of mantle cell lymphoma who presented with one-year history of pruritic furunculous skin lesion on the right elbow. Punch biopsy of the lesion showed an ulceration and dense inflammatory infiltrate that is composed predominately of eosinophils, neutrophils and lymphocytes. The infiltrate involves the entire dermis and extends to the subcutaneous tissue. The flame figures with degenerative collagen are also noted. A Periodic acid-Schiff (PAS) stain with adequate controls fails to reveal fungal hyphae. The histologic changes are consistent with Wells syndrome, which clinically resembles cellulitis, often with blister formation. This is a prime example of the value in performing the punch biopsy in this patient and educating the clinician about the pathogenesis of this type of skin lesion. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 44-year-old man with eruptions of bilateral blisters or circumferential erythema on his lower legs. It mentions that the patient was diagnosed with Churg-Strauss syndrome, eosinophilic cellulitis and bullous pemphigoid as well as treated through prednisolone and corticosteroid. An overview of the disease's association with giardiasis is also presented.

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).

The article describes the case of eosinophilic cellulitis (EC) in a 68-year-old man induced by administration of interferon (IFN)-Β. Immunohistochemical staining for p signal transducers and activator of transcription (pSTAT) and pSTAT6 for 3 cases of ordinary, idiopathic EC. It found that repeated local injection of IFN-Β may have generated matured dendritic cell (DC) at the injection site.

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 child who developed Wells' syndrome or eosinophilic cellulitis on both feet. It describes the clinical presentation of the child. It details his medical history and the laboratory examinations administered to the patient. The article also discusses the diagnosis of eosinophilic cellulitis.

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.

Since Wells and Smith first described cases of eosinophilic cellulitis (Wells syndrome; WS) in 1979, it has been noted that some but not all patients with WS present with eosinophilia. In the face of idiopathic persistent eosinophilia patients will also then fall within the hypereosinophilic syndrome (HES), which represents a multifarious spectrum of disorders of varying severity, causes and outcomes. In this article we propose that patients who present within the HES spectrum with cutaneous findings of WS and with no extracutaneous disease be classified as having 'persistent hypereosinophilia with Wells syndrome' (PHEWS). [ABSTRACT FROM AUTHOR]

Wells' syndrome or "eosinophilic cellulitis" is characterized by clinical features of cellulitis and histological pictures of eosinophils infiltrate of the dermis with some « flame » figures. This is a very rare disease in the pediatric age. We report the case of a 14-month-old boy, presented with two farms painful nodular brownish lesions in the thigh and back of the foot as well as multiple erythematous papular and vesicular lesions on the forehead, cheeks, limbs and trunk. Biological analysis and histological examination confirmed the diagnosis of Wells' syndrome. The outcome was favorable with dermocorticoid., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Background: Well's syndrome, or eosinophilic cellulitis, is rare in childhood, with fewer than 40 pediatric cases being reported since 1979. The physiopathology is unknown., Patients and Methods: In February 2012, members of the research group of the Department of Pediatric Dermatology Society submitted their case of Wells' syndrome in children aged 0-15 years. Details of clinical, biological and histological features and of therapeutic strategies were collected by physicians using a standardized questionnaire. Pictures were reviewed by the authors., Results: Eleven patients were included (average age: 6 years), with a strong prevalence of atopy (63%). Two types of clinical manifestation were noted: single or multiple cellulitis associated or not with vesiculobullous lesions and fixed urticaria. Eighty-two percent of patients had pruritus and 73% had eosinophilia. For all patients, histological examination of skin biopsies showed an eosinophilic infiltrate extending in the dermis with associated Sweet-like neutrophilic infiltrate being seen in 2 patients. The course of the disease was protracted (mean duration: 8 months) with flare-ups. Treatment varied depending on the doctors (topical or systemic steroids, tacrolimus and dapsone)., Discussion: Our study confirms some of the data in the literature concerning the clinical, histological features and course of Well's syndrome in children. The key information is the high prevalence of atopic children hitherto unreported. In a setting of insect bites, vaccination, infection or traumatism, this unusual background could explain the onset of inflammatory reaction with eosinophils. Oral or topical steroids appear to be the first-line treatment in children when necessary., Conclusion: Well's syndrome in children is rare and characterized by its polymorphism. We report for the first time in a series of patients a high prevalence of atopy, which raises new perspectives in understanding these rare diseases. We propose topical steroids as first-line therapy in children with superficial lesions, with oral steroids being given for cellulitic lesions or where topical therapy fails., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Background: Churg-Strauss syndrome often involves the skin, and this may sometimes reveal the disease., Observation: A 25-year-old woman was referred to a gynaecologist for inflammation of the right breast with breast discharge. Cytological analysis of the liquid showed numerous inflammatory cells, particularly polymorphonuclear eosinophils and neutrophils. Ultrasound examination of the breast was consistent with galactophoritis. CRP was normal, and hypereosinophilia was seen. The patient was subsequently referred to a dermatology unit. Skin examination revealed inflammation of the entire breast, which was painful, warm and erythematous; the border was oedematous with blisters. Necrotic lesions were also present on the thumbs and knees. Skin biopsy of the breast showed a dermal infiltrate with abundant infiltrate of polymorphonuclear eosinophils, including patchy necrosis and intraepidermal vesicles. Histological examination of a biopsy sample from a thumb revealed eosinophilic granuloma and leukocytoclastic vasculitis. The patient was also presenting asthma, pulmonary infiltrates and mononeuropathy at L3, consistent with Churg-Strauss syndrome., Discussion: Breast involvement in Churg-Strauss syndrome is very rare (only one other case has been reported). This is the first case in which the breast condition revealed the disease. Cutaneous involvement of the breast is, however, also compatible with Wells' cellulitis. The lesions quickly disappeared with 1mg/kg/d oral prednisolone., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Introduction: Eosinophilic cellulitis (Wells' syndrome) is an inflammatory dermatitis that is often misdiagnosed as infectious cellulitis due to its similarity in presentation. Misdiagnosis leads to delay of correct treatment and inappropriate use of antibiotics., Methods: A case series of eosinophilic cellulitis and a literature review are presented., Results: Patients with Wells' syndrome may present with a variety of nonspecific symptoms, such as fever, arthralgia and malaise, as well as myriad cutaneous lesions with associated erythema, presenting as blisters, bullae, papules and/or nodules. Several treatment modalities have been used to treat eosinophilic cellulitis and have been met with variable success rates; these include systemic corticosteroids, topical corticosteroids and antihistamines, with success rates of 91.7%, 50% and 25%, respectively., Conclusions: A high degree of clinical suspicion must be exercised to diagnose this rare condition. Cellulitis with an atypical presentation or not responding to appropriate antibiotic treatment should trigger suspicion of Wells' syndrome. To date, the most successful treatment method is a short course of systemic corticosteroids.