Pediatric Wells syndrome (eosinophilic cellulitis) after vaccination: A case report and review of the literature.

Ashley M Yu, Shinya Ito, Tom Leibson, Sasson Lavi, Lisa W Fu, Miriam Weinstein, Sandra M Skotnicki

Journal: Pediatric dermatology 2018;35(5):e262-e264

PMID: 29998475

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Abstract

A 4-year-old boy presented with erythematous vesicular plaques, ulceration, edema, and pruritus on the left foot and ankle 10 days after receiving the tetanus, diphtheria, pertussis, and polio; measles, mumps, rubella, and varicella; and hepatitis A/B vaccines. Biopsy showed eosinophilic infiltrates and flame figures, suggesting Wells syndrome. Patch testing showed a 1+ reaction to neomycin and aluminum hydroxide, with a recall reaction of Wells syndrome of the feet bilaterally. We report a rare case of pediatric Wells syndrome triggered by nonthimerosal vaccine components confirmed by patch testing.

Address: Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.; Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children, Toronto, ON, Canada.; Division of Immunology and Allergy, Hospital for Sick Children, Toronto, ON, Canada.; Section of Dermatology, Division of Paediatric Medicine, Hospital for Sick Children, Toronto, ON, Canada.; Division of Dermatology, University of Toronto, Toronto, ON, Canada.; Department of Occupational and Environmental Health, St. Michael's Hospital, Toronto, ON, Canada.

DOI: 10.1111/pde.13532

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MeSH Terms: Adjuvants, Immunologic, Aluminum Hydroxide, Anti-Bacterial Agents, Cellulitis, Child, Preschool, Eosinophilia, Glucocorticoids, Humans, Male, Neomycin, Patch Tests, Skin, Vaccination