Wells syndrome, a rare eosinophilic cutaneous disorder, also called eosinophilic cellulitis, exhibits significant clinical heterogenicity. It typically presents as erythematous infiltrated plaques, primarily on the extremities. Initially, these lesions often exhibit similarities to erysipelas or cellulitis but do not respond to antimicrobial therapy. Contribution of IL-5, abnormal Th2 cells, and activated eosinophilic granulocytes suggests a nonspecific hypersensitivity reaction to exogenous or endogenous stimuli. Wells syndrome is a diagnosis of exclusion that can be recognised by its clinical course, and histological findings. Corticosteroids are the mainstay treatment, helps alleviate the ongoing, relapsing pattern. We are reporting a case of 50 years old male presented to us with complaint of itchy red raised lesions that has recurrent course. On physical examination, multiple erythematous plaques were identified over bilateral lower limb. Skin biopsy specimen was sent for histopathological examination which showed eosinophilic infiltration around peri-appendageal structures confirming the diagnosis of Wells syndrome. It is a rare, relapsing skin disorder of unknown cause which is difficult to diagnose specially on first episode. For mild cases, topical corticosteroids are often sufficient. However, in most of the cases, oral steroids show rapid resolution. Gradual reducing dosage of corticosteroids across a month is usually easily tolerated by the patients whereas low maintenance dose with corticosteroids helps in preventing recurrences.
| Published in | International Journal of Clinical Dermatology (Volume 8, Issue 1) |
| DOI | 10.11648/j.ijcd.20250801.14 |
| Page(s) | 22-25 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2025. Published by Science Publishing Group |
Wells Syndrome, Eosinophilic Cellulitis, Flame Figures
IL | Interleukin |
Th2 | T helper 2 |
EC | Eosinophilic Cellulitis |
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APA Style
Sharma, T., Vishwakarma, A. K. (2025). Wells Syndrome: A Rare Recurrent Eosinophilic Dermatosis in a Tertiary Care Hospital. International Journal of Clinical Dermatology, 8(1), 22-25. https://doi.org/10.11648/j.ijcd.20250801.14
ACS Style
Sharma, T.; Vishwakarma, A. K. Wells Syndrome: A Rare Recurrent Eosinophilic Dermatosis in a Tertiary Care Hospital. Int. J. Clin. Dermatol. 2025, 8(1), 22-25. doi: 10.11648/j.ijcd.20250801.14
AMA Style
Sharma T, Vishwakarma AK. Wells Syndrome: A Rare Recurrent Eosinophilic Dermatosis in a Tertiary Care Hospital. Int J Clin Dermatol. 2025;8(1):22-25. doi: 10.11648/j.ijcd.20250801.14
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Download@article{10.11648/j.ijcd.20250801.14,
author = {Tripti Sharma and Ajay Kumar Vishwakarma},
title = {Wells Syndrome: A Rare Recurrent Eosinophilic Dermatosis in a Tertiary Care Hospital
},
journal = {International Journal of Clinical Dermatology},
volume = {8},
number = {1},
pages = {22-25},
doi = {10.11648/j.ijcd.20250801.14},
url = {https://doi.org/10.11648/j.ijcd.20250801.14},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcd.20250801.14},
abstract = {Wells syndrome, a rare eosinophilic cutaneous disorder, also called eosinophilic cellulitis, exhibits significant clinical heterogenicity. It typically presents as erythematous infiltrated plaques, primarily on the extremities. Initially, these lesions often exhibit similarities to erysipelas or cellulitis but do not respond to antimicrobial therapy. Contribution of IL-5, abnormal Th2 cells, and activated eosinophilic granulocytes suggests a nonspecific hypersensitivity reaction to exogenous or endogenous stimuli. Wells syndrome is a diagnosis of exclusion that can be recognised by its clinical course, and histological findings. Corticosteroids are the mainstay treatment, helps alleviate the ongoing, relapsing pattern. We are reporting a case of 50 years old male presented to us with complaint of itchy red raised lesions that has recurrent course. On physical examination, multiple erythematous plaques were identified over bilateral lower limb. Skin biopsy specimen was sent for histopathological examination which showed eosinophilic infiltration around peri-appendageal structures confirming the diagnosis of Wells syndrome. It is a rare, relapsing skin disorder of unknown cause which is difficult to diagnose specially on first episode. For mild cases, topical corticosteroids are often sufficient. However, in most of the cases, oral steroids show rapid resolution. Gradual reducing dosage of corticosteroids across a month is usually easily tolerated by the patients whereas low maintenance dose with corticosteroids helps in preventing recurrences.
},
year = {2025}
}
TY - JOUR T1 - Wells Syndrome: A Rare Recurrent Eosinophilic Dermatosis in a Tertiary Care Hospital AU - Tripti Sharma AU - Ajay Kumar Vishwakarma Y1 - 2025/04/29 PY - 2025 N1 - https://doi.org/10.11648/j.ijcd.20250801.14 DO - 10.11648/j.ijcd.20250801.14 T2 - International Journal of Clinical Dermatology JF - International Journal of Clinical Dermatology JO - International Journal of Clinical Dermatology SP - 22 EP - 25 PB - Science Publishing Group SN - 2995-1305 UR - https://doi.org/10.11648/j.ijcd.20250801.14 AB - Wells syndrome, a rare eosinophilic cutaneous disorder, also called eosinophilic cellulitis, exhibits significant clinical heterogenicity. It typically presents as erythematous infiltrated plaques, primarily on the extremities. Initially, these lesions often exhibit similarities to erysipelas or cellulitis but do not respond to antimicrobial therapy. Contribution of IL-5, abnormal Th2 cells, and activated eosinophilic granulocytes suggests a nonspecific hypersensitivity reaction to exogenous or endogenous stimuli. Wells syndrome is a diagnosis of exclusion that can be recognised by its clinical course, and histological findings. Corticosteroids are the mainstay treatment, helps alleviate the ongoing, relapsing pattern. We are reporting a case of 50 years old male presented to us with complaint of itchy red raised lesions that has recurrent course. On physical examination, multiple erythematous plaques were identified over bilateral lower limb. Skin biopsy specimen was sent for histopathological examination which showed eosinophilic infiltration around peri-appendageal structures confirming the diagnosis of Wells syndrome. It is a rare, relapsing skin disorder of unknown cause which is difficult to diagnose specially on first episode. For mild cases, topical corticosteroids are often sufficient. However, in most of the cases, oral steroids show rapid resolution. Gradual reducing dosage of corticosteroids across a month is usually easily tolerated by the patients whereas low maintenance dose with corticosteroids helps in preventing recurrences. VL - 8 IS - 1 ER -
Department of Pathology, Military Hospital, Panagarh, India
Department of Dermatology, Venereology & Leprosy, Government Medical College, Haldwani, India
Figure 1. Multiple erythematous, oedematous plaques involving lower limb with hyperpigmentation on resolving area.
Figure 2. H&E, x40 Histopathological examination revealed a moderately dense superficial and deep perivascular, as well as peri-appendageal, infiltrate composed of eosinophils and lymphocytes. Additionally, several eosinophils were interspersed throughout the interstitium of reticular dermis and surrounding the deep vascular plexus.
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