Abstract: There are rare reports on the successful treatment of Wells syndrome complicated with allergic bronchopulmonary aspergillosis (ABPA) using mepolizumab combined with glucocorticoids. This paper presents one such case. The patient was a 24-year-old female with recurrent generalized rash and pruritus for 1 month, which had aggravated for 5 days. She had a previous medical history of allergic bronchopulmonary aspergillosis (ABPA) and allergic rhinitis. After admission, chest CT showed multiple infectious foci in both lungs, bronchial wall thickening with mucus impaction, and bronchiectasis in the left lower lobe. The peripheral blood IgE and absolute eosinophil count were significantly elevated. Physical examination revealed scattered wheals on the trunk and extremities and tense blisters on the right ankle. Combined with the typical pathological feature of flame figures, a diagnosis of Wells syndrome complicated with ABPA was made. Following treatment with mepolizumab, glucocorticoids, and itraconazole, the cutaneous and respiratory symptoms improved, and no recurrence was observed during the 1-year follow-up.

Key words: allergic bronchopulmonary aspergillosis, Wells syndrome, eosinophilic cellulitis, mepolizumab