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EOSINOPHILIC DISEASES

Wells Syndrome

Therapeutic Approach

Wells syndrome is a rare inflammatory skin disorder characterized clinically by pruritic erythematous plaques resembling cellulitis and histologically by dermal edema, eosinophil infiltration, and “flame figures.” Lesions usually improve drastically after systemic glucocorticoid administration. Recurrent or persistent cases can be effectively maintained with the administration of low-dose prednisone every other day. In refractory cases, minocycline, dapsone, griseofulvin, and antihistamines may be beneficial. Cyclosporine and IFN-α have also been used with success. For the treatment of localized or mild disease, medium- to high-potency topical corticosteroids may be sufficient. It also can be beneficial to treat the underlying condition or triggering factor, if identified. See Table 25-1.

Table 25-1Wells Syndrome Treatment Table

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