Is it really possible to differentiate insect bite-like reaction and nodular variant of eosinophilic cellulitis in a healthy person?

摘要

Exaggerated insect bite reaction and Wells' syndrome were considered distinct entities. Recently it has been suggested that there is considerable overlap [1]. We present a patient with an exaggerated insect bite reaction which seems to be an overlapping condition with nodular variant of eosinophilic cellulitis and we suggest that this condition should be named an "insect bite-like reaction". A 52-year-old woman was referred to our clinic with a 7-day history of a tender lesion with swelling, erythema and ulceration on her abdomen. The patient complained of reduced appetite, fatigue and myalgia, together with the onset of this lesion. She denied a history of recent travel, contact with animals, trauma or insect bites. Systemic sulbactam-ampicilline was prescribed by her general practitioner had been unhelpful. Dermatological examination revealed an indurated nodule with central ulceration on her right abdominal region.