Eosinophilic Cellulitis Wells Research Articles

Luna stain: a simple and cost-effective diagnostic tool helps in detecting eosinophilic granules deposition of flame figures and aids in diagnosing eosinophilic cellulitis Wells Syndrome

ABSTRACT We report a rare case of Wells syndrome in which a 61-year-old Caucasian male presented with three distinct skin lesions including a cutaneous bulla, an erythematous plaque, and a linear streak located on the patient’s left anterior thigh, left dorsal wrist, and left anterior forearm, respectively. Histologic examination revealed diffuse and interstitial eosinophilic infiltrate admixed with lymphocytes and macrophages that predominantly involve the dermis. Nodular aggregates of eosinophils surrounding dermal collagen fibers suggestive of ‘flame figures’ were identified. Luna histochemical stain was used and highlighted the deposition of eosinophilic granules over the collagen bundles confirming the presence of flame figures. Laboratory workup revealed peripheral eosinophilia, but a comprehensive clinical evaluation failed to reveal a systemic disease and ultimately the diagnosis of eosinophilic cellulitis ‘Wells Syndrome’ was rendered. After a short course of immunosuppressive therapy, the patient experienced a complete resolution of the skin lesions on his last follow-up visit several weeks from the initial diagnosis. This case highlights the various clinical forms that Wells syndrome may present with and may serve as a good example for the use of Luna stain as a simple and cost-effective diagnostic tool that can help to arrive at the accurate diagnosis and inform therapy.

Wells' syndrome after primoinfection by parvovirus B19 in a child

To the Editor: The diagnosis of eosinophilic cellulitis—Wells' syndrome (WS)—is based on both recurrent skin lesions and histologic features.1 Clinically, WS presents as a local erythema and edema of the skin resembling bacterial cellulitis with minor systemic symptoms. The histologic picture shows dermal edema, infiltration of eosinophils, and flame figures. Involution and healing occur after several weeks of recurrent skin manifestations.2 Among the numerous associated disorders, parvovirus B19 (PB19) infection has not, to our knowledge, been reported.