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December 1989

Low-Dose Alternate-Day Prednisone for Persistent Wells' Syndrome

Author Affiliations

University of Cincinnati (Ohio) Medical Center; Northwestern University Medical School, Chicago, Ill

Arch Dermatol. 1989;125(12):1625-1626. doi:10.1001/archderm.1989.01670240025006

REPORT OF A CASE  A 26-year-old white female was initially diagnosed as having Wells' syndrome (eosinophilic cellulitis) in 1979, and was described in the literature in 1984.1 She gave no history of insect bites or chemical exposure. During the last 10 years she has had multiple episodes of recurrent swollen, weeping, erythematous plaques that occurred mainly on the face (Figure), but that also arose on the upper extremities and shoulders. These plaques resolved, first with central clearing, after 2 to 3 weeks. Occasionally these plaques developed bullae on a firm indurated base. Histopathologically, her skin biopsy specimens show characteristic eosinophilic infiltrates, with some lymphocytes and histiocytes, edema surrounding dermal blood vessels, and flame figures. She was also noted to have a peripheral eosinophilia of up to 8%. She has had repeated normal blood cell counts (except for the eosinophilia noted above), and has had normal examination results for stool ova

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