Eosinophilic cellulitis (Wells' syndrome): a new case description

\Background Wells' syndrome was first described by Wells in 1971 as a recur rent granulomatous dermatitis with eosinophilia and was later named eosinop hilic cellulitis. It is defined by the following criteria: (i) sudden onset of annular or circinate erythematous-edematous patches that rapidly evolve to morphea-like blue-slate-colored plaques; (ii) a histological picture us ually 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, oval-shaped, reddish-violet, moderately i tchy, erythematous-edematous patches on both arms about 2 months before our observation. Results The remote pathologic history showed that the woman have been submi tted to quadrantectomy with lymph node dissection followed by cobalt therap y for breast cancer. Based on the pharmacological history, intake of drugs was excluded. Routine blood chemistry and instrumental tests did not show a ny alteration, nor did assays of the main autoantibodies, complement, circu lating immunocomplexes, or tumor markers. Conclusions Histologically the picture was compatible with the diagnosis of Eosinophilic cellulitis. Following topical corticosteroid therapy the lesi on 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 foll ow-up. (C) 1999 Elsevier Science B.V. All rights reserved.