Eosinophilic cellulitis (Wells syndrome)

Eosinophilic cellulitis (Wells' syndrome) is a rare disorder characterized clinically by recurrent erythematous plaques resembling cellulitis and hist ologically by a dermal infiltrate of lymphocytes, eosinophils and eosinophi l debris between collagen bundles, forming flame figures in typical cases. A 71-year-old woman with Wells' syndrome with blood and bone marrow eosinop hilia showed a good response to dapsone. The level of eosinophil cationic p rotein (ECP) in serum was elevated. Immunophenotyping of peripheral T cells revealed an increased proportion of CD3+CD4+ T cells. The patients' cultur ed peripheral lymphocytes spontaneously released significant amounts of int erleukin 5 (IL-5), but not interleukin 4 (IL-4) or interferon gamma (IFN ga mma). These findings suggest that activated T cells may be involved in the pathogenesis of blood and tissue eosinophilia in this patient.