Wells Syndrome: Response to Dapsone Therapy

Bokotas, C.; Kouris, Anargyros; Stefanaki, Christina; Sgotzou, Themis; Christofidou, Elefteria; Kontochristopoulos, George

doi:10.5021/ad.2014.26.4.541

Cited by 12 publications

(10 citation statements)

References 5 publications

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“…The use of dapsone in the treatment regimen of eosinophilic cellulitis has been reported quite often . After failure of systemic steroids, 100 mg dapsone was initiated daily, showing a remission of lesions within a short period of 2 weeks.…”

Section: Resultsmentioning

confidence: 99%

“…After failure of systemic steroids, 100 mg dapsone was initiated daily, showing a remission of lesions within a short period of 2 weeks. Afterwards the dose of dapsone was reduced to 50 mg daily for 6 weeks and later to 50 mg thrice a week . Another treatment regimen suggests 200 mg/day at the beginning of the therapy …”

Section: Resultsmentioning

confidence: 99%

“…The use of dapsone in the treatment regimen of eosinophilic cellulitis has been reported quite often. 4,[27][28][29] After failure of systemic steroids, 100 mg dapsone was initiated daily, showing a remission of lesions within a short period of 2 weeks. Afterwards the dose of dapsone was reduced to 50 mg daily for 6 weeks and later to 50 mg thrice a week.…”

Section: Dapsonementioning

confidence: 99%

“…Afterwards the dose of dapsone was reduced to 50 mg daily for 6 weeks and later to 50 mg thrice a week. 28 Another treatment regimen suggests 200 mg/day at the beginning of the therapy. 27 The exact action mechanism of dapsone in eosinophilic cellulitis is still unknown, but it is certain that the substance inhibits the eosinophilic peroxidase which is part of the eosinophilic granula and induces mast cell degranulation.…”

Section: Dapsonementioning

confidence: 99%

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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: Resultsmentioning

confidence: 99%

Section: Dapsonementioning

confidence: 99%

Section: Dapsonementioning

confidence: 99%

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

Räßler

Lukács

Elsner

2016

Acad Dermatol Venereol

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“…In some cases, patients with recalcitrant disease also responded to dapsone (Figure ) and other antiinflammatory or immunomodulatory agents (among others interferon‐α, chloroquine, cyclosporine, tacrolimus) . Dapsone and (hydroxy‐)chloroquine are thought to have effects on eosinophil function by affecting myeloperoxidase activity and chemotaxis, respectively . There have been various case reports describing the successful use of antihistamines and antifungal agents as well as TNF‐α inhibitors .…”

Section: Therapeutic Optionsmentioning

confidence: 99%

Wells syndrome

Weins

Biedermann

Weiss

et al. 2016

J Deutsche Derma Gesell

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Summary A rare eosinophilic dermatosis, Wells syndrome, also referred to as eosinophilic cellulitis, is characterized by great clinical variability. Typical findings include infiltrated erythematous plaques arising on the extremities. Lesions initially resemble erysipelas/cellulitis, however, they do not improve with antibiotic treatment. Eosinophilic cellulitis is a diagnosis of exclusion that may only be made over the course of the disease, taking into account clinical and characteristic histological findings (flame figures). Although multiple potential triggers have been proposed, the exact etiology remains unresolved. Involvement of abnormal Th2 cells, IL‐5, and activated eosinophilic granulocytes suggest a nonspecific hypersensitivity response to exogenous or endogenous stimuli. Corticosteroids may have a beneficial effect on the chronic, recurrent course frequently observed. The disease is often self‐limiting, healing without sequelae. Given that transitions to hematological and oncological disorders have been observed, patients should be closely followed up.

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Eosinophilic Dermatoses: Recognition and Management

Marzano

Genovese

2020

Am J Clin Dermatol

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Wells Syndrome: Response to Dapsone Therapy

Cited by 12 publications

References 5 publications

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

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

Wells syndrome

Eosinophilic Dermatoses: Recognition and Management

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