Wells syndrome

Other Names

Eosinophilic cellulitis; Bullous cellulitis with eosinophilia; Wells' syndrome

Clinical features

• Wells syndrome is a rare eosinophilic disorder that primarily affects the skin.
• Affected people typically develop a skin rash that is often preceded by itching or burning skin.
• The rash consists of raised, red, swollen areas that may be warm to the touch.
• The symptoms generally come on rapidly and may last four to eight weeks. In some cases, the rash may recur (occur frequently or repeatedly) for years.

Cause

The exact underlying cause of Wells syndrome is currently unknown; however, some scientists believe that it may be an autoimmune reaction. Oral or topical corticosteroids are commonly used to treat Wells syndrome, although antifungal drugs, antibiotics, immunosuppressants, and/or antihistamines have also been used with varying degrees of success.

Symptoms

• People with Wells syndrome generally develop a skin rash that is often preceded by itching or burning skin.
• The rash consists of raised, red, swollen areas that may be warm to the touch.
• The limbs (arms and legs) are the most commonly affected area of the body.
• Symptoms generally come on rapidly and may last for four to eight weeks.
• In some cases, the rash may recur (occur frequently or repeatedly) for years.
• Some people with Wells syndrome may experience symptoms that do not affect the skin, such as asthma, joint pain, fever, or fatigue.

Diagnosis

• A diagnosis of Wells syndrome is often suspected based on the presence of characteristic signs and symptoms.
• A skin biopsy may then be recommended to support the diagnosis.
• It is also important to exclude possible triggers of the condition which may require unique treatment protocols.

Treatment

• The skin symptoms associated with wells syndrome are typically treated with oral or topical corticosteroids such as Prednisone.
• Other medications that may be used to treat this condition include antifungal drugs, antibiotics, immunosuppressants, and/or antihistamines (H1 receptor antagonists)

Prognosis

• The long-term outlook (prognosis) for people with Wells syndrome is excellent.
• The condition usually resolves over the course of four to eight weeks and may clear up more quickly with treatment.
• Most people do not have residual scarring.
• In some affected people, the rash may recur (occur frequently or repeatedly).
• These cases may take years to ultimately resolve.