Ohtsuka T.
Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.
Clin Exp Dermatol 2009;34:e597–8.
Editor’s note: Eosinophilic cellulitis (or Well’s disease) is a rare disease characterized by multiple, rapidly evolving erythematous plaques that clinically resemble cellulitis. Histological examination reveals interstitial edema and a predominantly eosinophilic infiltrate in the dermis. The most distinctive feature is the so-called “flame figures”. These are basophilic collagen bundles coated with eosinophilic major basic protein released by degranulating eosinophils. The lesions resolve spontaneously after 2–8 weeks without scarring, but they often recur. During the active state of the disease, approximately half of the affected patients additionally have peripheral blood eosinophilia. Associations with eosinophilic cellulitis have been described with insect bites, medications, hemato-oncological disease, solid tumors, and parasitic, viral, and fungal infections. However, these associations are based only on scattered case reports. Eosinophilic cellulitis is usually treated with corticosteroids, antihistamines, or sometimes dapsone. The latter treatment is usually combined with systemic corticosteroids. Other therapeutic options that have been used include anti-inflammatory agents such as colchicines, antimalarial drugs, and immunosuppressive agents such as cyclosporine and azathioprine.