Wells syndrome: a case of successful treatment with omalizumab

Egeland, Øystein; Balieva, Flora; Undersrud, Erling

doi:10.1111/ijd.14006

Cited by 6 publications

(8 citation statements)

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“…New treatment modalities are on the horizon. Case reports on successful treatment of EC with monoclonal anti-IgE antibody omalizumab have been published [11]. Increased expression of IL-5 has been reported in several cases.…”

Section: Discussionmentioning

confidence: 99%

Wells Syndrome – An Odyssey

Heinig¹,

Vojvocic²,

Lotti³

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND: Wells syndrome is a rare idiopathic dermatosis of the eosinophilic spectrum. Diagnostic criteria include cutaneous eruptions of variable morphology with eosinophilic infiltrates, peripheral blood eosinophilia, a relapsing, remitting course, and exclusion of systemic disease. Diagnosis is often delayed. CASE PRESENTATION: We present a 28-year older man with recently developed pruritic and sometimes painful erythema. His medical history was positive for coughing in the evening that started in November 2012. Later, a pansinusitis developed. Early diagnosis improves the outcome. CONCLUSION: Standardized treatment has yet to be developed. In our case, systemic corticosteroids were of limited value only.

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Section: Discussionmentioning

confidence: 99%

Wells Syndrome – An Odyssey

Heinig¹,

Vojvocic²,

Lotti³

et al. 2019

Open Access Maced J Med Sci

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“…Wells syndrome is an uncommon dermatosis believed to be a type IV hypersensitivity reaction. 2,3 Although many variants of Wells syndrome have been observed, characteristics such as pruritic and tender erythematous plaques on gross observation, along with dermal infiltrate of eosinophils with "flame figures" on histology, tend to be suggestive of the diagnosis. 2,3 Said "flame figures" represent aggregates of major basic protein released from eosinophils which disintegrate the structural integrity of surrounding collagen and subsequently destroy local tissue.…”

Section: Introduction Case Reportmentioning

confidence: 99%

“…2,3 Although many variants of Wells syndrome have been observed, characteristics such as pruritic and tender erythematous plaques on gross observation, along with dermal infiltrate of eosinophils with "flame figures" on histology, tend to be suggestive of the diagnosis. 2,3 Said "flame figures" represent aggregates of major basic protein released from eosinophils which disintegrate the structural integrity of surrounding collagen and subsequently destroy local tissue. 1 In addition to characteristic histological features, Wells syndrome criteria that were seen in our patient also include a recurrent course of cutaneous manifestations, no evidence of triggering factors, and inconsistent blood eosinophilia.…”

Section: Introduction Case Reportmentioning

confidence: 99%

“…1 Treatment options for Wells syndrome include corticosteroids, antihistamines, antibiotics, immunosuppressants, and biologics. 2 We present a case of Wells syndrome that was unresponsive to corticosteroids, antivirals, antibiotics, antihistamines, and dapsone. This case reflects one of the few reported instances of Wells syndrome that was successfully treated with omalizumab.A 39-year-old female with no significant past medical history presented with a three-year history of small pruritic papules located on the face, extremities, and genitals (Figure 1).…”

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confidence: 99%

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Wells Syndrome with Sustained Response to Omalizumab

et al. 2022

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Wells syndrome (eosinophilic cellulitis), a rare dermatosis that arises from a multitude of triggers, may present with pruritic and erythematous plaques, papules, vesicles, or blisters.1 We present a case of Wells syndrome that was successfully treated with omalizumab. A 39-year-old female presented with a three-year history of diffusely located pruritic papules. After a negative lab and infectious workup, a punch biopsy showed dense eosinophilic infiltrate in the dermis as well as “flame figure” formation. Unsuccessful trials of prednisone, cetirizine, hydroxyzine, and dapsone prompted the use of omalizumab, which yielded excellent control of symptoms. Omalizumab’s success in the Wells syndrome disease process may be explained by its anti-inflammatory effects on IgE autoantibodies and receptors.5 Few cases of Wells syndrome treated with omalizumab have been reported. Thus, increased research to thoroughly elucidate omalizumab’s pharmacological mechanism of action in this particular disease process is warranted and would be a valuable contribution to the Wells syndrome literature.

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“…In 2018, Egeland et al [5] published the first case of a patient successfully treated with omalizumab. This drug is well established as second-line treatment of chronic spontaneous urticaria.…”

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confidence: 99%