title: [Wells syndrome mimicking facial cellulitis: Three cases].
abstract: BACKGROUND
  Wells syndrome, or eosinophilic cellulitis, is an uncommon inflammatory dermatosis of unknown etiology that is characterized by clinical features of pruritic cellulitis-like plaques on the extremities and a histological picture of eosinophilic infiltrate of the dermis with "flame figures".
  
  
  METHODS
  Herein, we report three cases of idiopathic Wells syndrome masquerading as bacterial facial cellulitis. Under treatment with oral prednisone and/or combined therapy with levocetirizine and hydroxyzine, all patients showed a dramatic improvement of their skin lesions.
  
  
  CONCLUSIONS
  These cases highlight the need to consider Wells syndrome 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 combined therapy with levocetirizine and hydroxyzine may be successfully used as first-line therapy or to prevent relapse after discontinuation of corticosteroid treatment.
authors.affiliation: Service de dermatologie, centre hospitalier de Saint-Brieuc, 10, rue Marcel-Proust, 22000 Saint-Brieuc, France.
authors.forename: C
authors.initials: C
authors.lastname: Gallard
authors.affiliation: Service de dermatologie, centre hospitalier de Saint-Brieuc, 10, rue Marcel-Proust, 22000 Saint-Brieuc, France.
authors.forename: S
authors.initials: S
authors.lastname: Law-Ping-Man
authors.affiliation: Service de dermatologie, centre hospitalier de Saint-Brieuc, 10, rue Marcel-Proust, 22000 Saint-Brieuc, France.
authors.forename: L
authors.initials: L
authors.lastname: Darrieux
authors.affiliation: Cabinet Armor pathologie, 4, place Konrad-Adenauer, 22194 Plérin, France.
authors.forename: L
authors.initials: L
authors.lastname: Tisseau
authors.affiliation: Service de dermatologie, centre hospitalier de Saint-Brieuc, 10, rue Marcel-Proust, 22000 Saint-Brieuc, France. Electronic address: gilles.safa@ch-stbrieuc.fr.
authors.forename: G
authors.initials: G
authors.lastname: Safa
mesh_terms: D000328:Adult; D000982:Antipruritics / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis; D002481:Cellulitis / Q000175:diagnosis*; D017332:Cetirizine / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004802:Eosinophilia / Q000175:diagnosis*; D005148:Facial Dermatoses / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006919:Hydroxyzine / Q000627:therapeutic use; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use
chemical_list: D000982:Antipruritics; D006919:Hydroxyzine; C472067:levocetirizine; D011241:Prednisone; D017332:Cetirizine
keywords: Cellulite faciale; Cellulite à éosinophiles; Eosinophilic cellulitis; Facial cellulitis; Syndrome de Wells; Wells syndrome