[Wells syndrome mimicking facial cellulitis: Three cases]

Abstract

Background: 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".

Patients and methods: 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.

Discussion: 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.

Keywords: Cellulite faciale; Cellulite à éosinophiles; Eosinophilic cellulitis; Facial cellulitis; Syndrome de Wells; Wells syndrome.