Gallard C, Law-Ping-Man S, Darrieux L, Tisseau L, Safa G
Service de dermatologie, centre hospitalier de Saint-Brieuc, 10, rue Marcel-Proust, 22000 Saint-Brieuc, France.
Cabinet Armor pathologie, 4, place Konrad-Adenauer, 22194 Plérin, France.
Ann Dermatol Venereol. 2017 Apr;144(4):284-289. doi: 10.1016/j.annder.2016.09.676. Epub 2016 Nov 10.
Wells syndrome, or eosinophilic cellulitis, is an uncommon inflammatory dermatosis of unknown etiology that is characterized by clinical features of pruritic cellulitis-like plaques on the extremities and a histological picture of eosinophilic infiltrate of the dermis with "flame figures".
Herein, we report three cases of idiopathic Wells syndrome masquerading as bacterial facial cellulitis. Under treatment with oral prednisone and/or combined therapy with levocetirizine and hydroxyzine, all patients showed a dramatic improvement of their skin lesions.
These cases highlight the need to consider Wells syndrome in the differential diagnosis when evaluating a patient with facial cellulitis that does not respond to an initial antimicrobial regimen. In addition, our cases suggest that combined therapy with levocetirizine and hydroxyzine may be successfully used as first-line therapy or to prevent relapse after discontinuation of corticosteroid treatment.
韦尔斯综合征，即嗜酸性粒细胞性蜂窝织炎，是一种病因不明的罕见炎症性皮肤病，其特征为四肢出现瘙痒性蜂窝织炎样斑块的临床特征以及真皮嗜酸性粒细胞浸润伴“火焰状图形”的组织学表现。
在此，我们报告三例伪装成细菌性面部蜂窝织炎的特发性韦尔斯综合征病例。在口服泼尼松和/或左西替利嗪与羟嗪联合治疗下，所有患者的皮肤病变均有显著改善。
这些病例强调，在评估对抗菌初始治疗方案无反应的面部蜂窝织炎患者时，鉴别诊断中需考虑韦尔斯综合征。此外，我们的病例表明，左西替利嗪与羟嗪联合治疗可成功用作一线治疗或预防皮质类固醇治疗停药后的复发。
