title: Diagnosis and management of eosinophilic cellulitis (Wells' syndrome): A case series and literature review.
abstract: BACKGROUND
  Eosinophilic cellulitis (Wells' syndrome) is an inflammatory dermatitis that is often misdiagnosed as infectious cellulitis due to its similarity in presentation. Misdiagnosis leads to delay of correct treatment and inappropriate use of antibiotics.
  
  
  METHODS
  A case series of eosinophilic cellulitis and a literature review are presented.
  
  
  RESULTS
  Patients with Wells' syndrome may present with a variety of nonspecific symptoms, such as fever, arthralgia and malaise, as well as myriad cutaneous lesions with associated erythema, presenting as blisters, bullae, papules and/or nodules. Several treatment modalities have been used to treat eosinophilic cellulitis and have been met with variable success rates; these include systemic corticosteroids, topical corticosteroids and antihistamines, with success rates of 91.7%, 50% and 25%, respectively.
  
  
  CONCLUSIONS
  A high degree of clinical suspicion must be exercised to diagnose this rare condition. Cellulitis with an atypical presentation or not responding to appropriate antibiotic treatment should trigger suspicion of Wells' syndrome. To date, the most successful treatment method is a short course of systemic corticosteroids.
authors.affiliation: McGill University, Montreal, Quebec.
authors.forename: Hani
authors.initials: H
authors.lastname: Sinno
authors.forename: Jean-Philip
authors.initials: JP
authors.lastname: Lacroix
authors.forename: James
authors.initials: J
authors.lastname: Lee
authors.forename: Ali
authors.initials: A
authors.lastname: Izadpanah
authors.forename: Ronnie
authors.initials: R
authors.lastname: Borsuk
authors.forename: Kevin
authors.initials: K
authors.lastname: Watters
authors.forename: Mirko
authors.initials: M
authors.lastname: Gilardino
keywords: Cellulitis; Eosinophilia; Eosinophilic cellulitis; Flame figures; Wells’ syndrome