Wells' syndrome. Recurrent granulomatous dermatitis with eosinophilia

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Abstract
Cases (2) of granulomatous dermatitis with eosinophilia (Wells'' syndrome) were reported. With Wells'' original 4 cases, these 2 cases define a distinctive dermatosis with onset as cellulitis and formation of solid edema and either final spontaneous resolution or resolution with steroid therapy. Microscopic study showed diffuse tissue eosinophillia and fibrinoid flame figures, evolution of associated focal necrobiosis and formation of focal microgranulomas associated with eosinophils. Biopsy of muscle and fascia showed comparable fasciitis and eosinophilic myositis. Immunofluorescence in 1 case disclosed fibrin in the dermis and Ig[immunoglobulin]M, IgA, and C3 [complement component 3] in the blood vessels of the muscle. Recurrences of the lesions often appeared to be related to drug administration or surgery. [Wells'' syndrome may be a hypersensitivity syndrome].

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