Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2013 Dec 30;7(4):113-20.
doi: 10.3315/jdcr.2013.1157. eCollection 2013.

Wells syndrome (eosinophilic cellulitis): Proposed diagnostic criteria and a literature review of the drug-induced variant

Affiliations
Case Reports

Wells syndrome (eosinophilic cellulitis): Proposed diagnostic criteria and a literature review of the drug-induced variant

Kara Heelan et al. J Dermatol Case Rep. .

Abstract

Background: Wells syndrome is an uncommon inflammatory dermatosis first described in 1971 by Wells. The clinical eruption is characterized by varying morphology and severity and usually follows a relapsing remitting course. The majority of the reported cases are of unknown etiology, drug induced Wells syndrome has rarely been reported. A literature search using MEDLINE was performed. We recorded the features of our case and of the additional cases of drug induced Wells syndrome in the literature.

Main observations: Including our case there are 25 cases of drug-induced Wells syndrome reported. Causative drugs include antibiotics, anticholinergic agents, anaesthetics, non-steroidal anti-inflammatory agents, thyroid medications, chemotherapeutic agents, thiomersal containing vaccinations, anti-tumor necrosis factor agents and thiazide diuretics.

Conclusions: To the authors knowledge this is the first reported case of drug-induced Wells syndrome from thiazide diuretics. The diagnosis of Wells syndrome is often controversial and we propose a set of diagnostic criteria.

Keywords: aliskiren; antibiotics; diuretic; drug reaction; drug-induced; eosinophilia; etanercept; hydrochlorothiazide; hypertension; penicillin.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Erythematous swollen plaques on right forearm.
Figure 2
Figure 2
Erythematous lesions on the back.
Figure 3
Figure 3
Hematoxylin and eosin (400 x) stain showing flame figures.

References

    1. Wells GC. Recurrent granulomatous dermatitis with eosinophilia. Trans St Johns Hosp Dermatol Soc. 1971;57:46–56. - PubMed
    1. Spigel GT, Winkelmann RK. Wells' syndrome. Recurrent granulomatous dermatitis with eosinophilia. Arch Dermatol. 1979;115:611–613. - PubMed
    1. Wells GC, Smith NP. Eosinophilic cellulitis. Br J Dermatol. 1979;100:101–109. - PubMed
    1. Mitchell AJ, Anderson TF, Headington JT, Rasmussen JE. Recurrent granulomatous dermatitis with eosinophilia. Wells' syndrome. Int J Dermatol. 1984;23:198–202. - PubMed
    1. Caputo R, Marzano AV, Vezzoli P, Lunardon L. Wells syndrome in adults and children: a report of 19 cases. Arch Dermatol. 2006;142:1157–1161. - PubMed

Publication types

LinkOut - more resources