cqvip:For cellulitis that does not respond to conventional antimicrobial treatment, clinicians should consider, among other explanations, several noninfectious diso rders that might masquerade as infectious cellulitis. Diseases that commonly mas querade as this condition in clude thrombophlebitis, contact dermatitis, insect stings, drug reactions, eosinophilic cellulitis (the Wells syndrome), gouty arth ritis, carcinoma erysipelatoides, familial Mediterranean fever, and foreign-bod y reactions. Diseases that uncommonly masquerade as infectious cellulitis includ e urticaria, lymphedema, lupus erythematosus, sarcoidosis, lymphoma, leukemia, P aget disease, and panniculitis. Clinicians should do an initial diagnostic work -up directed by the findings from a detailed history and complete physical exam ination. In many cases, skin biopsy is the only tool that helps identify the cor rect diagnosis. Special tests may also be needed.
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