A case of Eosinophilic Cellulitis causing orbital edema and ecchymosis in a child

To describe an unusual case of Eosinophilic Cellulitis (Wells' Syndrome) with orbital involvement presenting in a 10-year-old boy, which was successfully treated with systemic corticosteroids after incisional biopsy and pathologic diagnosis.

A 10-year-old boy was referred to our emergency department with a sudden onset of painless ecchymosis and edema of his left periorbital region. Computed tomography was concerning for orbital cellulitis, however, the history and clinical presentation were inconsistent with this radiographic diagnosis. The patient underwent an incisional biopsy with pathology revealing eosinophilic cellulitis. The patient's condition resolved after treatment with oral corticosteroids.

Eosinophilic cellulitis is a rare dermatosis characterized by large, inflamed, edematous patches. It usually affects adults and is mainly located on the extremities. This is a unique case due to the patient demographics and the location of this disease, with only a few orbital eosinophilic cellulitis cases reported in the literature.