Wells Syndrome: An Enigmatic and Therapeutically Challenging Disease

Wells syndrome, also known as eosinophilic cellulitis, is an uncommon condition whose etiology often remains a mystery. Patients present with recurrent cutaneous swellings that are often cellulitic in appearance. Histopathologic evaluation of the skin lesions reveals a dense dermal eosinophilic infiltrate, marked edema, and characteristic “flame figures.” Notably, the picture is devoid of vasculitis. Therapy with low-dose systemic steroids has proven variably successful. Clinical evidence lending support for the efficacy of other medications has been, for the most part, anecdotal. We present a case of Wells syndrome, review the literature, and discuss therapeutic options.