Toxocariasis and Wells' syndrome: a causal relationship?
BACKGROUND
The etiology of Wells' syndrome or eosinophilic cellulitis is unknown. Various triggering factors, such as myeloproliferative disorders, lymphoma, infections/infestations, insect bites and drugs have been reported. In 1979, Wells was the first who pointed out some common features of eosinophilic cellulitis and skin lesions in toxocariasis.


OBJECTIVE
We report 2 patients who exhibited the characteristic clinical and histological features of Wells's syndrome together with elevated antibody titers to the excretory-secretory antigen of Toxocara canis.


RESULTS
In both patients, the skin lesions disappeared after oral albendazole treatment and no recurrences were observed. The clinical response was followed by a normalization of the Toxocara antibody titer. In contrast, a patient with eczematoid skin lesions, eosinophilia and an elevated Toxocara antibody titer did not benefit from albendazole treatment despite serological normalization.


CONCLUSIONS
Taken together, these cases lend support to a causal relationship of Toxocara in selected patients with Wells' syndrome.
Hurni
M A
MA
Dermatological Clinic, University of Berne, Inselspital, Berne, Switzerland.
Gerbig
A W
AW
Braathen
L R
LR
Hunziker
T
T
D000284:Administration, Oral; D000368:Aged; D015766:Albendazole / Q000008:administration & dosage / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage / Q000627:therapeutic use; D000909:Antibodies, Helminth / Q000032:analysis; D000947:Antigens, Helminth / Q000276:immunology; D002481:Cellulitis / Q000188:drug therapy / Q000209:etiology*; D004485:Eczema / Q000188:drug therapy / Q000209:etiology; D004802:Eosinophilia / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007816:Larva Migrans, Visceral / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000188:drug therapy / Q000209:etiology*; D013577:Syndrome; D017166:Toxocara canis / Q000276:immunology
D000871:Anthelmintics; D000909:Antibodies, Helminth; D000947:Antigens, Helminth; D015766:Albendazole