Wood C, Miller A C, Jacobs A, Hart R, Nickoloff B J
Am J Dermatopathol. 1986 Jun;8(3):186-93. doi: 10.1097/00000372-198606000-00002.
We report five cases, all male, of diverse clinical findings of scattered erythematous, violaceous, or centrally blue plaques. Eight biopsies from the five patients showed nodular or diffuse dermal and subcutaneous infiltration, predominantly of eosinophils and histiocytes, with "flame figures" composed of granules of eosinophils that surround collagen bundles, whose staining quality is thereby altered. Two patients were children, the younger only 18 months old. Three patients initially presented clinical evidence of insect bites, and in one of these the biopsy showed cutaneous pseudolymphoma underlying dermal changes of eosinophilic cellulitis. Eosinophilic infiltration with flame figures is a distinctive reaction to various stimuli. It may be seen in a wide variety of clinical conditions and is not confined solely to patients with Wells' syndrome, which may be an acceptable term for clinically typical cases. Eosinophilic infiltration with flame figures is preferred descriptively to identify the microscopic changes in Wells' syndrome and in other cases like that of our patient with pseudolymphoma, in which the cutaneous reaction may be secondary to some other disease.
我们报告了5例患者，均为男性，临床表现为散在的红斑、紫斑或中央呈蓝色的斑块。对这5例患者进行了8次活检，结果显示结节状或弥漫性真皮及皮下浸润，主要为嗜酸性粒细胞和组织细胞，可见由嗜酸性粒细胞颗粒围绕胶原束形成的“火焰状图形”，胶原束的染色性质因此改变。2例患者为儿童，年龄较小的仅18个月。3例患者最初有昆虫叮咬的临床证据，其中1例活检显示在嗜酸性蜂窝织炎的真皮改变下方存在皮肤假性淋巴瘤。伴有火焰状图形的嗜酸性浸润是对各种刺激的一种独特反应。它可见于多种临床情况，并不局限于韦尔斯综合征患者，对于临床典型病例，韦尔斯综合征可能是一个可接受的术语。从描述性角度来看，伴有火焰状图形的嗜酸性浸润更适合用于识别韦尔斯综合征以及其他类似我们假性淋巴瘤患者的病例中的微观变化，在这些病例中，皮肤反应可能继发于其他某种疾病。
