Eosinophilic cellulitis

Eosinophilic cellulitis, also known as Wells' syndrome, is a rare skin condition characterized by highly inflammatory lesions that may appear anywhere on the body. The hallmark of this condition is the presence of eosinophils, a type of white blood cell, in the affected skin areas. Eosinophilic cellulitis is of unknown etiology, though it is thought to be a hypersensitivity reaction to various triggers.

Symptoms and Signs

The symptoms of eosinophilic cellulitis can vary but typically include the sudden onset of itchy, red, and swollen areas on the skin. These areas may evolve into plaques or nodules and often have a characteristic orange peel appearance. The lesions may be accompanied by fever and general malaise. Unlike other forms of cellulitis, eosinophilic cellulitis lesions are more likely to recur and can persist for weeks to months before resolving, sometimes leaving behind temporary or permanent skin discoloration.

Causes

The exact cause of eosinophilic cellulitis remains unknown. It is believed to be an immune-mediated condition, possibly triggered by infections, insect bites, drugs, or underlying health conditions that stimulate an eosinophilic response. However, in many cases, no specific trigger can be identified.

Diagnosis

Diagnosis of eosinophilic cellulitis is primarily based on clinical examination and the characteristic histopathological findings in a skin biopsy. The biopsy will show an infiltration of eosinophils in the dermis and sometimes flame figures, which are aggregates of eosinophilic granules and degenerated collagen. Differential diagnosis includes other forms of cellulitis, dermatitis, and eosinophilic granuloma.

Treatment

Treatment of eosinophilic cellulitis typically involves systemic corticosteroids to reduce inflammation and control symptoms. In cases where corticosteroids are contraindicated or not effective, other immunosuppressive agents such as dapsone or cyclosporine may be used. Antihistamines can help manage itching. Identifying and avoiding potential triggers is also an important aspect of management.

Prognosis

The prognosis for eosinophilic cellulitis is generally good, with most cases responding well to treatment. However, the condition can recur, requiring ongoing management and follow-up with a dermatologist.

Epidemiology

Eosinophilic cellulitis is a rare condition, and its exact prevalence is unknown. It can occur in individuals of any age, gender, or ethnicity, though some studies suggest a slight predominance in adults.

See Also

• Cellulitis
• Eosinophilia
• Dermatitis
• Immunosuppression