Abstract |
A 69-year-old woman with chronic lymphocytic leukaemia presented with an 18-month history of pruritic, tender, erythematous plaques. The recurrent lesions simulated insect bites and cellulitis, but failed to respond to appropriate treatments. A recent severe flare was associated with markedly elevated inflammatory markers and swelling of the left leg. The swelling settled rapidly with ibuprofen, leaving cellulitis around a small ulcer infected with Staphylococcus aureus and Streptococcus pyogenes. The cellulitis responded to oral flucloxacillin. Subsequent multiple small exaggerated insect bite reaction lesions settled with oral prednisolone. Eosinophilic cellulitis ( Wells' syndrome) was considered unlikely based on the lack of a morphoea-like resolution phase, histological lack of flame figures and presence of vasculitis; however, the distinction is probably artificial.
|
Authors | Patrick Walker, Dorota Long, Craig James, Gillian Marshman |
Journal | The Australasian journal of dermatology
(Australas J Dermatol)
Vol. 48
Issue 3
Pg. 165-9
(Aug 2007)
ISSN: 0004-8380 [Print] Australia |
PMID | 17680967
(Publication Type: Case Reports, Journal Article)
|
Topics |
- Aged
- Cellulitis
(complications, pathology)
- Diagnosis, Differential
- Eosinophilia
(diagnosis)
- Erythema
(etiology)
- Female
- Granuloma, Pyogenic
(drug therapy, etiology, pathology)
- Humans
- Insect Bites and Stings
(complications, pathology)
- Leg
(pathology)
- Leukemia, Lymphocytic, Chronic, B-Cell
(complications)
- Skin
(pathology)
- Syndrome
|