Wells' syndrome (eosinophilic cellulitis) secondary to infliximab

Tugnet, Nicola; Youssef, Amgad; Whallett, Andrew

doi:10.1093/rheumatology/ker322

Cited by 21 publications

(15 citation statements)

References 7 publications

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“…It is assumed that repeated injections of anti‐TNF alpha may cause an augmented hypersensitivity reaction resulting in conditions like Wells syndrome . In a single report, Wells syndrome was seen as a secondary reaction to infliximab infusions …”

Section: Resultsmentioning

confidence: 99%

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%

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

Räßler

Lukács

Elsner

2016

Acad Dermatol Venereol

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“…Drugs which have been reported to have a causal relationship with WS include antibiotics, 1-3,7-12 anticholinergic agents, 2 anaesthetics, 2,7,9 non-steroidal anti-inflammatory agents, 2,9,12 thyroid medications, 2,11 chemotherapeutic agents, 8,13 thiomersal containing vaccinations 14-16 and anti-TNF agents. [17][18][19] Of the twenty-five reported cases eighteen were female and the ages of onset ranged from 3.5 years to 85 years old. Peripheral eosinophilia was reported in 17 cases, this was normal in 4 cases and not reported in 4 other cases.…”

Section: Discussionmentioning

confidence: 99%

Wells syndrome (eosinophilic cellulitis): Proposed diagnostic criteria and a literature review of the drug-induced variant

Heelan

Ryan

Shear

et al. 2013

J Dermatol Case Rep

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“…Both infl iximab and adalimumab have been associated with the development of eosinophilic cellulitis ( 7,8 ). We initially postulated that our patient's hypersensitivity was because of a reaction to the chimeric portion of the infl iximab antibody ( 7 ), despite the lack of anti-chimeric antibodies.…”

Section: Conflict Of Interestmentioning

confidence: 97%