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Eosinophilic cellulitis: five cases
R Lindskov1, N Illum, K Weismann
1Department of Dermatology, Rigshospitalet, University of Copenhagen, Denmark.
Insights
Eosinophilic cellulitis (Wells' syndrome) can affect young children, presenting with unusual scalp lesions and necrotizing granulomas. Early diagnosis and steroid therapy are crucial for managing this rare condition.
Area of Science:
- Dermatology
- Pediatric Dermatology
- Pathology
Background:
- Eosinophilic cellulitis, also known as Wells' syndrome, is a rare inflammatory skin condition.
- Previous reports have included limited pediatric cases.
Observation:
- This study details five cases of eosinophilic cellulitis.
- Four out of five patients were under 10 years old, with one as young as 20 months.
- One child presented with unique hard, tender subcutaneous scalp swellings.
Findings:
- Histological examination of the scalp lesions revealed extensive subcutaneous necrotizing granulomas.
- These specific granulomatous lesions have not been previously associated with eosinophilic cellulitis.
- The condition often shows a positive response to corticosteroid treatment.
Implications:
- Highlights the potential for eosinophilic cellulitis to occur in very young children.
- Emphasizes the importance of recognizing rare clinical and histological presentations.
- Underscores the need for clinicians and pathologists to be familiar with Wells' syndrome for timely and effective steroid therapy.
Abstract:
Five cases of eosinophilic cellulitis or Wells' syndrome are described. While only few children have been included in earlier reports, 4 of the 5 patients in the present paper were below 10 years of age, with the youngest being only 20 months when the disease started. One of the children developed hard and tender subcutaneous swellings on the scalp, the histology of which showed extensive subcutaneous necrotizing granulomas. Similar lesions have not been described previously in connection with eosinophilic cellulitis. Eosinophilic cellulitis may be called a rare disease. However, it is important that clinician and histopathologist are both acquainted with the pathological features of this condition, as the disease often responds readily to steroid therapy.