Eosinophilic cellulitis in Child
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Synopsis

Eosinophilic cellulitis, or Wells syndrome, is a rare disorder of unknown etiology. Eosinophilic cellulitis is reported infrequently in children and is manifested by eosinophil infiltration in the dermis.
Eosinophilic cellulitis presents with sudden onset of single or multiple mildly painful or pruritic, erythematous plaques. The lesions are usually seen on the extremities but may be anywhere on the skin and are typically symmetric or widespread. Uncommonly, fever and arthralgias are present. Spontaneous resolution tends to occur over 4-8 weeks. Recurrences may occur. Familial cases have been reported.
Cases may be associated with insect bites, viral infections, parasite infestations, fungal infections, vaccination, and hypersensitivity reactions. More rarely, leukemia, eosinophilic granulomatosis with polyangiitis, and hypereosinophilic syndrome have been reported.
Eosinophilic cellulitis presents with sudden onset of single or multiple mildly painful or pruritic, erythematous plaques. The lesions are usually seen on the extremities but may be anywhere on the skin and are typically symmetric or widespread. Uncommonly, fever and arthralgias are present. Spontaneous resolution tends to occur over 4-8 weeks. Recurrences may occur. Familial cases have been reported.
Cases may be associated with insect bites, viral infections, parasite infestations, fungal infections, vaccination, and hypersensitivity reactions. More rarely, leukemia, eosinophilic granulomatosis with polyangiitis, and hypereosinophilic syndrome have been reported.
Codes
ICD10CM:
L98.3 – Eosinophilic cellulitis
SNOMEDCT:
238931006 – Eosinophilic cellulitis
L98.3 – Eosinophilic cellulitis
SNOMEDCT:
238931006 – Eosinophilic cellulitis
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Bacterial cellulitis – It may be difficult clinically to differentiate between bacterial and eosinophilic cellulitis in some cases. In eosinophilic cellulitis, plaques are not usually warm or tender to the touch. A differential count may reveal peripheral eosinophilia in eosinophilic cellulitis and neutrophilia in bacterial cellulitis.
- Erysipelas
- Contact dermatitis
- Insect bites
- Fixed drug eruption
- Urticaria
- Granuloma annulare
- Morphea
- Erythema migrans
- Annular lichenoid dermatitis of youth
- Sweet syndrome
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:04/11/2018
Last Updated:05/06/2019
Last Updated:05/06/2019
Eosinophilic cellulitis in Child
See also in: Cellulitis DDx