Wells综合征七例临床病理分析

Wells syndrome： a clinical and histopathological review of seven cases

目的探讨Wells综合征的临床及病理特征和治疗情况。方法回顾性分析7例Wells综合征的临床及病理资料。结果7例患者中，皮损分别位于双下肢（4例）、背部（1例）、面部和躯干（1例）及臀部（1例）；临床表现为蜂窝织炎样（3例）、荨麻疹样（1例）、环状红色斑块（1例）和丘疹结节（2例）。组织病理学检查均示真皮内大量嗜酸粒细胞浸润，伴有“火焰征”，3例同时伴有血管炎改变。7例患者均无明显的发病诱因。3例给予小剂量糖皮质激素和雷公藤多苷口服，皮损基本消退。结论Wells综合征具有多种临床表现，组织学上具有特征性，系统性糖皮质激素和雷公藤多苷治疗有效。

Objective To assess the clinical and histopathological features as well as treatment of Wells syndrome. Methods The clinical and pathological findings from 7 patients with Wells syndrome were retrospectively reviewed. Results Lesions were located on both lower extremities in 4 patients, on the back in 1 patient, on the face and trunk in 1 patient, and on the buttocks in 1 patient. Clinical manifestations included cellulitis （n = 3）, urticaria （n = 1）, annular plaques （n = 1） and papulonodules（n = 2）. Histopathological examination of skin biopsies showed an infiltrate of numerous eosinophils with occasional flame figures in the dermis of all the patients. Leucocytoclastic vasculitis was found in 3 cases. No triggering factors were found in any of the 7 cases. The lesions nearly subsided in 3 patients after 2-week treatment with oral small-dosage prednisone and tripterygium glycosides. Conchlsions Wells syndrome shows a wide diversity of clinical mani- festations with distinct histological features. Systemic glucocorticoids and tripterygium glycosides are effective for the control of this condition.