1A 73-year-old woman developed general fatigue and high-grade fever in June 1996. She was diagnosed with myelodysplastic syndrome (MDS) following bone marrow examination. Immediately after granulocyte colony-stimulating factor (G-CSF) was started, distinctly circumscribed red skin eruptions appeared on her face, neck, back and forearms (A, long arrow). The histological examination of the skin biopsy specimen revealed a perivascular infiltration of neutrophils with no evidence of vasculitis (B), leading to the final diagnosis of Sweet's disease. After the cessation of G-CSF and administration of prednisone, the lesions started to vanish from the centre to the periphery (A, short arrow). Two months later, MDS progressed to overt leukaemia. The skin lesions reappeared without the administration of G-CSF. At this time, the eruptions did not respond to the adrenocorticosteroid treatment. The patient died from septic shock in October 1996. Sweet's syndrome is characterized by tender, red inflammatory nodules or papules, usually affecting the upper limbs, face or neck. It is part of the group of acute neutrophilic dermatoses, including pyoderma gangrenosum, but can be distinguished by its unique appearance and distribution. Histological examination shows a dense dermal infiltrate of mature neutrophils. Recently, this disease has also been reported in association with various haematological malignancies and the use of G-CSF. Haematologists should be aware of this skin disease as a complication of haematological malignancy.
No takes yet. Share an insight, caveat, or question.
Matsumura et al. (2001) studied this question.