Wells Syndrome with atypical presentation
a diagnostic challenge
DOI:
https://doi.org/10.47456/rbps.v26isupl_3.13Keywords:
Cellulitis, Eosinophilia, Skin DiseasesAbstract
Introduction: Wells Syndrome is a rare, benign eosinophilic dermatosis. It classically presents with a sudden and recurrent eruption of infiltrated erythematous plaques on the limbs. Papulonodular lesions and systemic signs are uncommon. Diagnosis is based on clinical and histopathological findings. This report describes an atypical presentation of Wells Syndrome, presenting a diagnostic challenge. Objective: To emphasize the importance of recognizing atypical forms and maintaining clinical suspicion to avoid delayed diagnosis. Case Report: Man, years old exhibited a sudden and recurrent cutaneous condition for 13 years. The condition began with vesicles and bullae associated with fever and arthralgia, evolving into painful papules and nodules that discharged serosanguineous fluid on the limbs and trunk. Laboratory tests revealed eosinophilia and positive rheumatoid factors. Histopathology showed dense eosinophilic infiltration in the dermis and areas of eosinophilic degeneration of collagen (flame figures), characteristic of Wells Syndrome. Conclusion: The case demonstrates papulonodular lesions with an atypical form, the diagnosis of which was supported by characteristic histopathology and peripheral eosinophilia. The importance of patient follow-up is emphasized, as it may be triggered by myeloproliferative diseases.
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References
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