53-year old female patient with maculo-papular skin patches on the back. Clinically suspecting tumid lupus, erythema multiforme vs. pseudo-lymphoma.
Case Discussion
Wells syndrome (eosinophilic cellulitis) is an uncommon condition, of unknown aetiology. One report describes a patient with non-Hodgkin’s lymphoma, who presented successively with Wells syndrome, leukocytoclastic vasculitis and Sweet syndrome (Consigny 2001 Ann Dermatol Venereol), suggesting at least a certain degree of overlap between these entities. It is usually sporadic, although some association may be present with arthropod bites, infections, autoimmune diseases and leukaemias. In this patient, another lesion was simultaneously biopsied, which was diagnosed as discoid lupus erythematosus (see related content). Although these represent distinct diagnoses, a common pathophysiology cannot be excluded in this case.
Sections show sparing of the epidermis, with perivascular lymphocytic infiltrates. Numerous eosinophils are seen throughout, rimming the fatty tissue in the subcutis. Occasional flame figures are also seen.
See Related Content for references:
1) Consigny, S., et al. Ann Dermatol Venereol. 2001 Mar;128(3 Pt 1):213-6
Yoon, J., Ghazarian, D. Skin, Eosinophilic cellulitis. Digital Laboratory Medicine Library, Dept of Laboratory Medicine & Pathobiology, University of Toronto. Published
. Accessed December 17, 2025. https://dev.dlml.cflabs.ca/image/skin-eosinophilic-cellulitis-lmp69371
