Well’s
Syndrome
Epidemiology and Etiology:
- Most are
idiopathic
- Some are
associated with:
- Arthropod assaults
- Parasitic infestation
- Dermatophyte infection
- Drug allergy
- Atopic diathesis
- Internal malignancy
Common sites:
- Upper back
- Extremities
- Buttocks
Gross features:
- plaques
- arcuate
- erythematous
- indurated
Histologic features:
- diffuse infiltrate
of eosinophils
- massive early on
in course
- few lymphocytes
- may involve panniculus
- flame figures (degenerated collagen
produced by degranulation of eosinophils) (nonspecific)
- dermal collagen fibres coated in bright eosinophilic
granules (major basic protein)
- rimmed by
macrophages, sometimes giant cells
- subepidermal or intraepidermal
vesicle / bullae may be formed early on
Immunophenotype:
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Marker:
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Sensitivity:
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Specificity:
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Molecular features:
Other features:
References: