Document Detail

Exaggerated insect bite reaction exacerbated by a pyogenic infection in a patient with chronic lymphocytic leukaemia.
MedLine Citation:
PMID:  17680967     Owner:  NLM     Status:  MEDLINE    
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.
Patrick Walker; Dorota Long; Craig James; Gillian Marshman
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Australasian journal of dermatology     Volume:  48     ISSN:  0004-8380     ISO Abbreviation:  Australas. J. Dermatol.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-07     Completed Date:  2008-08-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0135232     Medline TA:  Australas J Dermatol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  165-9     Citation Subset:  IM    
Department of Dermatology, Flinders Medical Centre, Bedford Park, SA 5042, Australia.
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MeSH Terms
Cellulitis / complications,  pathology*
Diagnosis, Differential
Eosinophilia / diagnosis
Erythema / etiology
Granuloma, Pyogenic / drug therapy,  etiology*,  pathology
Insect Bites and Stings / complications*,  pathology
Leg / pathology
Leukemia, Lymphocytic, Chronic, B-Cell / complications*
Skin / pathology*

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