Molluscum Contagiosum and Cryosurgery: Triggering Factors for Wells' Syndrome?

Stavropoulos, Panagiotis; Kostakis, Panagiotis; Παναγιωτόπουλος, Αλέξανδρος; Papakonstantinou, Anastasia-Metaxia K.; Petridis, Athanassios; Georgala, S.

doi:10.1080/00015550310003746

Cited by 14 publications

(7 citation statements)

References 9 publications

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“…While some may consider Wells’ syndrome a distinct nosological entity, 4,5 we believe it represents a reactive state to one of the many conditions that trigger the degranulation of a large number of dermal eosinophils. These associations have been consistently reported in the literature, and include arthropod and insect bites, 6–10 viral infections (mumps, molluscum contagiosum, herpes simplex virus type 2, varicella, HIV), 1,11–15 parasitic infections (toxocariasis, ascariasis, onchocerciasis), 16–19 malignant solid tumours 20–22 and myeloproliferative disorders, 5,23 drugs 24 and vaccinations 25,26 . Thus, given our patient's clear history of a prolonged, cyclical course and unresponsiveness to therapy, we conducted an extensive work‐up to detect any underlying disorders.…”

Section: Discussionmentioning

confidence: 51%

Insect-bite-like Wells’ syndrome in association with mantle-zone lymphoma

Zeeli

Feinmesser

Segal

et al. 2006

British Journal of Dermatology

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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.

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Section: Discussionmentioning

confidence: 51%

Insect-bite-like Wells’ syndrome in association with mantle-zone lymphoma

Zeeli

Feinmesser

Segal

et al. 2006

British Journal of Dermatology

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“…However, in approximately one half of reported cases among children, there is no identifiable precipitating factor. 24 Reported precipitants have included bites or stings from ticks, bees, and spiders 8,9,12,[25][26][27][28] and infections with mumps, molluscum contagiosum, varicella, and herpes simplex virus. 1,24,29,30 There are also several reports of Wells' syndrome associated with bacterial, parasitic, and fungal infections.…”

Section: Discussionmentioning

confidence: 99%

“…24 Reported precipitants have included bites or stings from ticks, bees, and spiders 8,9,12,[25][26][27][28] and infections with mumps, molluscum contagiosum, varicella, and herpes simplex virus. 1,24,29,30 There are also several reports of Wells' syndrome associated with bacterial, parasitic, and fungal infections. 2,9,14,[31][32][33] Numerous medications have been implicated as triggers for Wells' syndrome.…”

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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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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“…MC‐associated eosinophilic cellulitis has been reported once 4 . In that case, repeated cryosurgery had been performed.…”

mentioning

confidence: 98%

“…S ir , Eosinophilic cellulitis is a rare dermatosis that has a clinical picture resembling acute cellulitis and a characteristic histopathology with dermal oedema and dense eosinophilic infiltration, which is called the flame figure 1,2 . Although the aetiology and pathogenesis of this condition are still unknown, various associated disorders, such as several viral infectious diseases, have been documented 2–5 . Recently, it has been reported that cryosurgery for molluscum contagiosum (MC) may be one of the triggering factors of eosinophilic cellulitis 4 .…”

mentioning

confidence: 99%