title: Wells' Syndrome Mimicking Facial Cellulitis: A Report of Two Cases.
abstract: Wells' syndrome (WS), or eosinophilic cellulitis, is an uncommon inflammatory dermatosis of unknown etiology that typically presents with pruritic cellulitis-like plaques on the extremities. Therefore, WS is often misdiagnosed as bacterial cellulitis due to its similarity in presentation. Here, we report two cases of WS that masqueraded as bacterial facial cellulitis. Under treatment with oral prednisone and/or a combination therapy with levocetirizine and hydroxyzine, both patients showed a dramatic improvement of the skin lesions. These cases highlight the need for clinicians to consider WS in the differential diagnosis when evaluating a patient with facial cellulitis that does not respond to an initial antimicrobial regimen. In addition, our cases suggest that combination therapy with levocetirizine and hydroxyzine may be successfully used as corticosteroid-sparing treatment or to prevent relapse after the discontinuation of corticosteroid treatment.
authors.affiliation: Department of Dermatology, Centre Hospitalier de Saint-Brieuc, Saint-Brieuc, Armor Pathology Laboratory, Plérin, France.
authors.forename: Maxence
authors.initials: M
authors.lastname: Cormerais
authors.affiliation: Department of Dermatology, Centre Hospitalier de Saint-Brieuc, Saint-Brieuc, Armor Pathology Laboratory, Plérin, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Poizeau
authors.affiliation: Department of Dermatology, Centre Hospitalier de Saint-Brieuc, Saint-Brieuc, Armor Pathology Laboratory, Plérin, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Darrieux
authors.affiliation: Armor Pathology Laboratory, Plérin, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Tisseau
authors.affiliation: Department of Dermatology, Centre Hospitalier de Saint-Brieuc, Saint-Brieuc, Armor Pathology Laboratory, Plérin, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Safa
keywords: Eosinophilic cellulitis; Facial cellulitis; Wells’ syndrome