Wells Syndrome Differential Diagnoses

Updated: Mar 23, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Diagnostic Considerations

Febrile eosinophilic cellulitis with toxocariasis [21] and infectious cellulitis (eg, bacterial) [41, 42] need to be considered in the differential diagnosis of Wells syndrome (eosinophilic cellulitis), as does bacterial facial cellulitis, [43] erysipelas, [44] and arachnid (tick) bites. [45] Distinction from Churg-Strauss syndrome is also required. [30, 46] Wells syndrome may need to be distinguished from bullous cellulitis and should be considered if a patient does not to respond to antibiotics. [34] Cutaneous dirofilariasis may also clinically resemble Wells syndrome. [47]  Also consider terbinafine-induced DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome. [48]

Differential Diagnoses