# Wells’ Syndrome Mimicking Angioedema and Revealing a Multiple Myeloma: A Case Report

## TL;DR

A rare skin condition called Wells’ syndrome was misdiagnosed as angioedema but led to the discovery of an underlying multiple myeloma in a 60-year-old man.

## Contribution

This case report highlights the diagnostic challenge of WS and its association with an underlying neoplastic condition.

## Key findings

- Wells’ syndrome can present with facial edematous plaques resembling angioedema.
- Smoldering multiple myeloma was identified as an underlying condition in this WS case.
- Histopathological confirmation is crucial for accurate diagnosis of WS.

## Abstract

Wells’ syndrome (WS), or eosinophilic cellulitis, is a rare inflammatory dermatosis with a variety of clinical presentations. It typically manifests with recurrent pruritic erythematous plaques and edematous swellings, which can be mistaken for other conditions, such as erysipelas or angioedema. We report an unusual presentation of WS localized on the face of a 60-year-old male with a history of recurrent facial plaques, mistakenly treated as angioedema. After an extensive evaluation, a diagnosis of smoldering multiple myeloma was revealed as an underlying neoplastic condition. This case highlights the importance of considering Wells’ syndrome in differential diagnoses of recurrent cellulitis-like presentations, even in the absence of peripheral eosinophilia, and underscores the need for histopathological confirmation for an accurate diagnosis.