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Case 14 (27th Annual Uniformed Services Dermatology Seminar, 2003) WELL'S SYNDROME (EOSINOPHILIC CELLULITIS)

Twede JVT - MedPix

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Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Case 14 (27th Annual Uniformed Services Dermatology Seminar, 2003) WELL'S SYNDROME (EOSINOPHILIC CELLULITIS)

History: History: 53 year-old Caucasian male fractured his right ankle one month later developing an ipsilateral deep venous thrombosis and pulmonary embolism. He then developed a contralateral deep venous thrombosis after being placed on coumadin. Soon thereafter, he received a blood transfusion while undergoing an angiograrn and developed an urticarial transfusion reaction over his trunk coincident with small, indurated red plaques on the lower extremities. Over the last 3 months, the plaques have spread up both extremities and the patient has developed pruritic erythematous papules over his abdomen and neck. Within one week of his initial presentation to dermatology, he developed total body pruritus, erythematous papules and plaques over his trunk and upper extremities, and bullae on the lateral aspect of his feet.

Findings: Laboratory: CBC, antithrombin 3, UA, protein C, protein S, SPEP, RPR, anticardiolipin, LFT's, chemistries, factor V leiden, all WNL Histopathology: The biopsy shows perivascular and interstitial eosinophils and lymphocytes throughout the papillary and reticular dermis. Focal collagen bundles laden with eosinophil granules. No evidence of panniculitis, vasculitis or interface dermatitis.

Exam: Examination: Erythematous, indurated, waxy confluent plaques over bilateral lower extremities with hypererythematous borders. Bullae were present overlying these waxy plaques on the lateral aspect of the feet. Scattered, round, erythematous papules and plaques over the trunk and upper extremities.

No MeSH data available.


Erythematous, indurated, waxy confluent plaques over bilateral lower extremities with hypererythematous borders. Bullae were present overlying these waxy plaques on the lateral aspect of the feet. Scattered, round, erythematous papules and plaques over the trunk and upper extremities
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MPX2143_synpic23395: Erythematous, indurated, waxy confluent plaques over bilateral lower extremities with hypererythematous borders. Bullae were present overlying these waxy plaques on the lateral aspect of the feet. Scattered, round, erythematous papules and plaques over the trunk and upper extremities


Case 14 (27th Annual Uniformed Services Dermatology Seminar, 2003) WELL'S SYNDROME (EOSINOPHILIC CELLULITIS)

Twede JVT - MedPix

Erythematous, indurated, waxy confluent plaques over bilateral lower extremities with hypererythematous borders. Bullae were present overlying these waxy plaques on the lateral aspect of the feet. Scattered, round, erythematous papules and plaques over the trunk and upper extremities
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2143&req=5

MPX2143_synpic23395: Erythematous, indurated, waxy confluent plaques over bilateral lower extremities with hypererythematous borders. Bullae were present overlying these waxy plaques on the lateral aspect of the feet. Scattered, round, erythematous papules and plaques over the trunk and upper extremities

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Case 14 (27th Annual Uniformed Services Dermatology Seminar, 2003) WELL'S SYNDROME (EOSINOPHILIC CELLULITIS)

History: History: 53 year-old Caucasian male fractured his right ankle one month later developing an ipsilateral deep venous thrombosis and pulmonary embolism. He then developed a contralateral deep venous thrombosis after being placed on coumadin. Soon thereafter, he received a blood transfusion while undergoing an angiograrn and developed an urticarial transfusion reaction over his trunk coincident with small, indurated red plaques on the lower extremities. Over the last 3 months, the plaques have spread up both extremities and the patient has developed pruritic erythematous papules over his abdomen and neck. Within one week of his initial presentation to dermatology, he developed total body pruritus, erythematous papules and plaques over his trunk and upper extremities, and bullae on the lateral aspect of his feet.

Findings: Laboratory: CBC, antithrombin 3, UA, protein C, protein S, SPEP, RPR, anticardiolipin, LFT's, chemistries, factor V leiden, all WNL Histopathology: The biopsy shows perivascular and interstitial eosinophils and lymphocytes throughout the papillary and reticular dermis. Focal collagen bundles laden with eosinophil granules. No evidence of panniculitis, vasculitis or interface dermatitis.

Exam: Examination: Erythematous, indurated, waxy confluent plaques over bilateral lower extremities with hypererythematous borders. Bullae were present overlying these waxy plaques on the lateral aspect of the feet. Scattered, round, erythematous papules and plaques over the trunk and upper extremities.

No MeSH data available.