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Wells' syndrome |
European Journal of Dermatology. Volume 9, Number 1, 61-2, January - February 1999, Votre diagnostic ?
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Free Article
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Author(s) : Ludovic ROUSSEAU, Marie BEYLOT-BARRY, Béatrice VERGIER, Marie-Sylvie DOUTRE, Claire BEYLOT |
Summary : A 29-year-old, West-Indian woman presented a two year history of widespread, pruritic urticarial lesions which developed into indurated plaques, persisting for weeks. The first eruption occurred in the West Indies. There was neither previous history of atopy, insect bites nor preceding illness. She received a systemic steroid (prednisone 0.5 mg/kg/day), that resulted in complete clearing of the lesions within fifteen days. Another flare-up occurred a few days after giving birth. A topical steroid (clobetasol) was effective this time.
She was seen in our department for the third recurrence. Her general health was good and she was apyretic. The urticarial papules had a centrifugal extension, forming annular, erythematous and indurated plaques on the arms and thighs (Fig. 1) with erythematous borders and occasional blistering (Fig. 2). Routine blood tests were within normal limits.
A biopsy specimen of an erythematous plaque revealed in the whole dermis, a diffuse infiltration of eosinophils. There were collagen bundles encrusted with eosinophilic granules characteristic of "flame figures" (Fig. 3). |
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