Eosinophilic cellulitis associated with squamous cell carcinoma of the bronchus

Farrar, C.W.; Guérin, D; Wilson, N. J. E.

doi:10.1046/j.1365-2133.2001.04418.x

Cited by 25 publications

(18 citation statements)

References 6 publications

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“…29,39 Other therapies reported to be successful include various antimicrobial agents, 2,5,6,9,10,13,49 colchicine, 13 antimalarial drugs, cyclosporine, 50 azathioprine, 5 interferon-␣, 51 psoralen with ultraviolet A, 52 and antihistamines. 10,43,53 The small numbers of cases and the fact that most reports are anecdotal make it difficult to draw conclusions regarding whether these therapies are truly effective or these cases resolved spontaneously. However, we think that first-line treatment for children should be systemic corticosteroid therapy, with the addition of topical steroid treatment depending on the extent of disease.…”

Section: Discussionmentioning

confidence: 99%

“…39 Several cases of Wells' syndrome among adults have been associated with hematologic disorders, 9,41 lymphoproliferative malignancies, 1,34,42 and carcinoma. 34,[43][44][45] Zachary et al 45 reported a case of Wells' syndrome in a 17-year-old girl with nasopharyngeal carcinoma, which is the only pediatric case of Wells' syndrome associated with malignancy reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

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Bullous “Cellulitis” With Eosinophilia: Case Report and Review of Wells' Syndrome in Childhood

Gilliam¹,

Bruckner

Howard³

et al. 2005

Pediatrics

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ABSTRACT. A 1-year-old girl presented with acute onset of edematous erythematous plaques associated with bullae on her extremities and accompanied by peripheral eosinophilia. She was afebrile, and the skin lesions were pruritic but not tender. The patient was treated with intravenously administered antibiotics for presumed cellulitis, without improvement. However, the lesions responded rapidly to systemic steroid therapy. On the basis of lesional morphologic features, peripheral eosinophilia, and cutaneous histopathologic features, a diagnosis of Wells' syndrome was made. Wells' syndrome is extremely rare in childhood, with 27 pediatric cases reported in the literature. Because it is seen so infrequently, there are no specific guidelines for evaluation and management of Wells' syndrome among children. W ells' syndrome, or eosinophilic cellulitis, is a rare, recurrent, inflammatory dermatosis of unknown pathogenesis. In 1971, Wells 1 described 4 patients with an acute pruritic dermatitis clinically resembling bacterial cellulitis but with histopathologic findings characterized by dermal eosinophilia, phagocytic histiocytes, and the presence of flame figures. He initially called this syndrome recurrent granulomatous dermatitis with eosinophilia but later simplified the name to eosinophilic cellulitis. 2 Wells' syndrome is seen more commonly among adults but has been observed among children. Some hypothesize that this syndrome may represent a hypersensitivity response to a circulating antigen. 2 Associated precipitants include insect bites, medication reactions, recent immunization, myeloproliferative disorders, malignancies, and infections. We describe a case of a young child with no identifiable triggering factors, and we review the evidence for evaluation and management of these pediatric cases. CASE REPORTA previously healthy, 1-year-old girl presented with acute onset of edematous erythematous plaques, with associated bullae, on her lower extremities and left arm (Fig 1). These lesions were pruritic but not painful, and the patient was afebrile. Her parents denied a history of insect bites, ingestion of medications, trauma, or other intercurrent illness. The patient's most recent immunizations had been received 3 months earlier. The patient did not have a history of asthma, and there was no family history of asthma or atopic disease.The patient was admitted with presumed bacterial cellulitis and was treated with intravenously administered oxacillin, without improvement. Her laboratory studies were significant for an elevated white blood cell count of 30 ϫ 10 9 cells per L, with peripheral eosinophilia of 48%. After the patient failed to respond to systemically administered antibiotics, examination of vesicle fluid was performed and revealed numerous eosinophils. Subsequently, the diagnosis of probable Wells' syndrome was made. Oral steroid therapy was started at 2 mg/kg, and the patient's cutaneous symptoms improved within 24 hours, leaving residual erythema and hyperpigmentation (Fig 2). Five days after the i...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bullous “Cellulitis” With Eosinophilia: Case Report and Review of Wells' Syndrome in Childhood

Gilliam¹,

Bruckner

Howard³

et al. 2005

Pediatrics

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“…Also, some cases of Wells' syndrome have been described after vaccinations, and it was proposed that the preservative thimerosol was the causative agent in those cases (19). Several cases of Wells' syndrome among adults have been associated with hematologic disorders, lymphoproliferative malignancies, and carcinoma (20)(21)(22). One of the key events in disease expression of Wells' syndrome appears to be aberrant and inadequate eosinophil skin homing.…”

Section: Discussionmentioning

confidence: 99%

Wells� syndrome in childhood: two case reports with review of the literature

Farina¹

2014

CDERM

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SummaryWells' syndrome, or eosinophilic cellulitis, is a rare disorder manifesting with acute erythematous and edematous plaques which resolve completely. Bullous lesions are uncommon, especially in childhood. We present two pediatric cases of bullous Wells' syndrome, one 3-year-old boy with atypical cutaneous manifestations and one 6-month-old girl with typical skin lesions. No trigger factors could be identified in both cases. Treatment with topical and systemic steroids was performed. Both patients had no recurrences after two years. Fortyfive pediatric cases of Wells' syndrome have been reported in the literature with an average age of onset of five years. In only seven cases bullous lesions were present. In about half of the patients a precipitating factor has been identified, including infections, arthropod bites, drug administration and hematologic disorders.

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“…vasculitis (Churg-Strauss syndrome) (7), chronic inflammatory diseases (ulcerative colitis) (8) and neoplasias. The literature includes a number of well-documented cases associated with subcutaneous injections of etanercept (9) and adalimumab (10), and with squamous cell carcinomas (11) and colon adenocarcinomas ( 12).…”

Section: Discussionmentioning

confidence: 99%