Bullous eosinophilic cellulitis caused by trauma

Abstract

Eosinophilic cellulitis is also called Wells' syndrome, and this is an acute pruritic dermatitis that resembles cellulitis. It usually appears as well-circumscribed erythematous plaques, but bullous lesions have rarely been reported. There are several precipitating factors, including drugs, arthropod bites, viral infections, parasitic infestations, leukemia and other malignancies. A 21-year-old male presented with a mildly pruritic vesiculobullous eruption on the dorsum of left foot after he had been pricked by a twig. Histopathologic examination showed intraepidermal blisters and spongiosis of the epidermis and a mixed inflammatory cell infiltration that consisted mostly of eosinophils throughout the dermis. These findings were consistent with the diagnosis of bullous eosinophilic cellulitis. He was treated daily with prednisolone 30 mg and the lesions rapidly resolved. There has been no recurrence of the lesions for 1 year of follow-up.