Granuloma Annulare-like Wells Syndrome in a Child - A Case Report

Wells syndrome (WS) is a rare inflammatory skin disease of unknown etiology. Possible triggers for WS include insect bites/stings, infections, medications, malignancies, and vaccination. Most cases have been reported in adults, but WS may also occur in children.

We report a case of idiopathic WS in a 12-year-old boy, who presented with pruritic papulonodular and granuloma annulare-like lesions on his legs. The patient had an excellent response to topical and systemic corticosteroids.

WS may present as plaque, granuloma annulare-like, urticaria-like, papulovesicular, bullous, papulonodular, or fixed drug eruption-like lesions. Erythematous annular lesions are most common in adults, while plaques are mostly found in children. The histopathologic features are dynamic, starting with dermal edema and infiltration of eosinophils, then flame figures develop, and finishing with the appearance of histiocytes and giant cells.

Our patient represents a rare pediatric case with granuloma annulare-like WS syndrome.