Successful Treatment of Steroid-Dependent Eosinophilic Cellulitis With Cyclosporine

Kim, Suhee; Kwon, Ji Eun; Kim, Hyo-Bin

doi:10.4168/aair.2013.5.1.62

Cited by 14 publications

(8 citation statements)

References 11 publications

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“…Some authors consider IL‐5 to be the most important therapeutic target of reducing eosinophilic diseases . There are case reports confirming the benefits of a cyclosporine therapy in patients previously being treated with prednisolone over several weeks . Herr et al ., who treated two patients with a daily dose of 1.25 or 2.5 mg/kg cyclosporine, reported a complete remission during 3–4 weeks therapy .…”

Section: Resultsmentioning

confidence: 99%

“…23 There are case reports confirming the benefits of a cyclosporine therapy in patients previously being treated with prednisolone over several weeks. 24 Herr et al, who treated two patients with a daily dose of 1.25 or 2.5 mg/kg cyclosporine, reported a complete remission during 3-4 weeks therapy. 25 The usual dose for cyclosporine therapy is 100 mg/day, but may be increased to 200 mg/day if the skin lesion recurs.…”

Section: Cyclosporinementioning

confidence: 98%

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Treatment of eosinophilic cellulitis (Wells syndrome) – a systematic review

Räßler

Lukács

Elsner

2016

Acad Dermatol Venereol

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Eosinophilic cellulitis (Wells syndrome) is a rare inflammatory skin disease defined by erythematous, tender, sometimes urticarial plaques, possibly with vesicles and bullae, and granulomatous eosinophilic infiltrates in the dermis. Usually the disease has a benign course with spontaneous remission within a few weeks. Nevertheless, recurrences are quite frequent and may occur for several years. The objective of this study was to review the so far reported treatment options for Wells syndrome in a systematic manner. This systematic review is based on a search on Medline, Embase and Cochrane Central Register for English and German articles from 1970 to 2015. Advices on the treatment of Wells syndrome are limited predominately to case reports or to small case series. There are no randomized controlled trials, and control groups are missing. A variety of treatment options for Wells syndrome were reported including topical and systemic corticosteroids, antihistamines, cyclosporine, dapsone, azathioprine, griseofulvin, doxycycline, minocycline, antimalarial medications, oral tacrolimus/topical tacrolimus, sulfasalazine, interferon alpha and gamma, TNF alpha inhibitors, colchicine and PUVA therapy. As well-designed, randomized controlled trials are missing, no guidelines for the treatment of this disease can be given. Due to the small number of patients and the frequent misdiagnosis of this clinical entity, the aim of this systematic overview is to call attention to this rare condition and to help clinicians to diagnose and treat Wells syndrome effectively. Due to the good prognosis and tendency to resolve, systemic treatment should be limited to cases resistant to local therapy or with widespread lesions.

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Section: Resultsmentioning

confidence: 99%

Section: Cyclosporinementioning

confidence: 98%

Treatment of eosinophilic cellulitis (Wells syndrome) – a systematic review

Räßler

Lukács

Elsner

2016

Acad Dermatol Venereol

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“…Ciclosporin impairs T-cell activation hence its value in lymphocytic-variant HES. There are also reports of sustained clinical responses when ciclosporin is added to prednisolone in previously steroid-resistant idiopathic HES (Zabel & Schlaak, 1991;Akiyama et al, 1997;Fukuta et al, 2001) and when used as a steroid-sparing agent in idiopathic paediatric HES (Nadarajah et al, 1997;Hosoki al, 2011) [and also in cases of eosinophilic cellulitis and fasciitis (Kim et al, 2013;Tahara et al, 2008)].…”

Section: Treatment Of Idiopathic Hypereosinophilic Syndromementioning

confidence: 99%

Guideline for the investigation and management of eosinophilia

et al. 2017

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The guideline group was selected to be representative of UKbased medical experts with an interest in myeloproliferative neoplasms and eosinophilia. PubMed and EMBASE were searched systematically for publications in English until August 2015 using the key words eosinophilia, hypereosinophilia, eosinophilic leukaemia and HES. The writing group produced the draft guideline, which was subsequently revised by consensus by members of the General Haematology and Haematooncology Task Forces of the British Committee for Standards in Haematology (BCSH). The guideline was then reviewed by a sounding board of UK haematologists and representatives from the Nordic MPN Study Group, the BCSH and the British Society for Haematology (BSH) Committee, and comments were incorporated where appropriate. The 'GRADE' system was used to quote levels and grades of evidence, details of which can be found in Table I. The objective of this guideline is to provide healthcare professionals with clear guidance on the investigation and management of eosinophilia. Guideline updateThere is no previous BCSH guideline for this topic. AimThe purpose of this guideline is to provide a practical approach to the investigation and management of eosinophilia. Key recommendations• The underlying cause of eosinophilia should be sought and possible eosinophil-associated end-organ damage should be evaluated (Grade 1B). Assessment of underlying cause• A detailed medical history should be taken and a thorough physical examination should be performed (Grade 1C). The history should include:o assessment for allergic disorders, skin rashes and cardiorespiratory, gastrointestinal and constitutional symptoms.o a detailed travel history, particularly for tropical travel; travel even in the remote past may be relevant.o a detailed drug history.• All patients should have a full blood count, blood film examination and routine tests of renal and liver function, a bone profile, lactate dehydrogenase, erythrocyte sedimentation rate and/or C-reactive protein and vitamin B12 assay (Grade 1C) • Patients who are otherwise well with mild to moderate eosinophilia between 0Á5 and 1Á5 3 10 9

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“…Eosinophilic cellulitis is an uncommon, inflammatory and recurrent disorder which is more frequently observed in adults than in children [3, 4]. Despite its etiology remaining unknown, hypersensitive responses to different stimuli such as insect bites, fungal and viral infections, medications (including TNF inhibitors), vaccinations, eczema and hematologic malignant disorders, among others [3, 4], have been proposed.…”

Section: Discussionmentioning

confidence: 99%

“…Despite its etiology remaining unknown, hypersensitive responses to different stimuli such as insect bites, fungal and viral infections, medications (including TNF inhibitors), vaccinations, eczema and hematologic malignant disorders, among others [3, 4], have been proposed.…”

Section: Discussionmentioning

confidence: 99%

Wells’ Syndrome Successfully Treated with Colchicine

et al. 2017

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Eosinophilic cellulitis is an uncommon, inflammatory and chronic disorder of unknown etiology. Corticosteroids are currently considered as the first-line treatment but they are not without significant disadvantages such as contraindications in steroid-resistant cases and patients with frequent recurrences. We report a patient suffering from Wells’ syndrome with a 24-year history of symptomatic and generalized skin lesions. After consultation in our department, treatment with colchicine 1 mg/day was prescribed resulting in large clinical improvement. No side effects have been recorded. To our knowledge, this is an original disease approach. Although small, our clinical experience supports the inclusion of colchicine in the drug armamentarium when treating patients suffering from Wells’ syndrome. Indeed, its excellent safety profile makes it very attractive for patients with frequent recurrent episodes who need secure options for the medium- and long-term disease control.

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Successful Treatment of Steroid-Dependent Eosinophilic Cellulitis With Cyclosporine

Cited by 14 publications

References 11 publications

Treatment of eosinophilic cellulitis (Wells syndrome) – a systematic review

Treatment of eosinophilic cellulitis (Wells syndrome) – a systematic review

Guideline for the investigation and management of eosinophilia

Wells’ Syndrome Successfully Treated with Colchicine

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