Sweet's Syndrome (Acute Febrile Neutrophilic Dermatosis)

Diagnosis: Sweet's Syndrome (Acute Febrile Neutrophilic Dermatosis)

Bilateral, reddish blue, large and edematous plaques on dorsum of the hands and forearms.

Clinical Presentation

Bilateral, reddish blue, large and edematous plaques on dorsum of the hands and forearms.

Clinical History

Submitted by Alaa Saad. Originally posted October 10, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Cellulitis • Erythema multiforme • Pyoderma gangrenosum • Drug eruption • Behçet disease • Leukemia cutis • Vasculitis

Key Learnings

• Acute febrile neutrophilic dermatosis • Classic triad: fever, neutrophilia, tender erythematous plaques • Three categories: classical (often post-URI or IBD), malignancy-associated (~20%, esp AML), drug-induced • Dramatic response to systemic corticosteroids (within 48 hours) — almost diagnostic • Pathergy may occur • Histology: dense dermal neutrophilic infiltrate without vasculitis • Drug causes: G-CSF, TMP-SMX, all-trans retinoic acid

Tags: sweet039s, syndrome, acute, febrile, neutrophilic, dermatosis, alaa saad