Sweet's Syndrome as a Prodromal Manifestation of Acute Myeloid Leukemia
,
Abstract
Sweet's syndrome is a rare dermatological condition characterized by a constellation of clinical features, including fever, neutrophilic leukocytosis, painful skin plaques, and dermal neutrophil infiltration. Various etiologies have been documented, encompassing both underlying diseases and pharmacological agents. We present a case involving a 35-year-old female patient who exhibited fever and progressive cutaneous lesions manifesting as a painful erythematous rash on the limbs and trunk. Initially misdiagnosed as seronegative lupus erythematosus, her condition did not improve. A skin biopsy revealed significant neutrophilic infiltration, and she subsequently developed leukocytosis, leading to a diagnosis of acute leukemia upon bone marrow examination. The patient was treated with chemotherapy, resulting in a relative improvement of her skin lesions.
1. Błaszczyk A, Trojan S, Fussek-Styga U, et al. Sweet Syndrome-A Review of Pathogenesis, Clinical Features, Diagnosis and Treatment. J Educ Health Sport. 2023; 30(1): 45-56.
2. Majed K, et al. SWEET SYNDROME PRESENTS WITH SEVERE SIRS. MedJEM. 2021; (26):19-21.
3. Merola, J., Sweet syndrome (acute febrile neutrophilic dermatosis): Pathogenesis, clinical manifestations, and diagnosis. UpToDate, 2018.
4. Cohen PR. Sweet's syndrome–a comprehensive review of an acute febrile neutrophilic dermatosis. Orphanet J Rare Dis. 2007:2:34.
5. Nelson CA, et al. Sweet syndrome in patients with and without malignancy: a retrospective analysis of 83 patients from a tertiary academic referral center. J Am Acad Dermatol. 2018;78(2):303-309.e4.
6. Weedon D. The vasculopathic reaction pattern. In: Weedon’s skin pathology. 3rd ed. Edinburgh: Churchill Livingstone/Elsevier; 2010. p. 198-9.
7. Casarin Costa JR, Rodrigues Virgens A, de Oliveira Mestre L, et al. Sweet Syndrome: Clinical Features, Histopathology, and Associations of 83 Cases. J Cutan Med Surg. 2017;21(3):211-216.
8. Trowsdale J, Knight JC. Major histocompatibility complex genomics and human disease. Annu Rev Genomics Hum Genet. 2013. 14: 301-23.
9. Chowell D, Morris LGT, Grigg CM, et al. Patient HLA class I genotype influences cancer response to checkpoint blockade immunotherapy. Science. 2018; 359(6375): 582-587.
10. Takahama H, Kanbe T. Neutrophilic dermatosis of the dorsal hands: a case showing HLA B54, the marker of Sweet's syndrome. Int J Dermatol. 2010;49(9):1079-80.
11. Su W, Liu HN. Diagnostic criteria for Sweet's syndrome. Cutis. 1986; 37(3): 167-174.
12. Von Den Driesch P, et al. Sweet's syndrome (acute febrile neutrophilic dermatosis). J Am Acad Dermatol. 1994;31(4):535-56; quiz 557-60.
13. Khan U, Rizvi H, Ali F, et al. Sweet syndrome: a painful reality. BMJ Case Rep. 2016:2016:bcr2016217606.
14. Cohen PR, Kurzrock R. Sweet's syndrome and cancer. Clin Dermatol, 1993; 11(1): 149-57.
15. Raza S, Kirkland RS, Patel AA, et al. Insight into Sweet's syndrome and associated-malignancy: a review of the current literature. Int J Oncol. 2013;42(5):1516-22.
16. Zheng S, Li SH, Tang SH, et al. Insights Into the Characteristics of Sweet Syndrome in Patients With and Without Hematologic Malignancy. Front Med (Lausanne). 2020:7:20.
1. Błaszczyk A, Trojan S, Fussek-Styga U, et al. Sweet Syndrome-A Review of Pathogenesis, Clinical Features, Diagnosis and Treatment. J Educ Health Sport. 2023; 30(1): 45-56.
2. Majed K, et al. SWEET SYNDROME PRESENTS WITH SEVERE SIRS. MedJEM. 2021; (26):19-21.
3. Merola, J., Sweet syndrome (acute febrile neutrophilic dermatosis): Pathogenesis, clinical manifestations, and diagnosis. UpToDate, 2018.
4. Cohen PR. Sweet's syndrome–a comprehensive review of an acute febrile neutrophilic dermatosis. Orphanet J Rare Dis. 2007:2:34.
5. Nelson CA, et al. Sweet syndrome in patients with and without malignancy: a retrospective analysis of 83 patients from a tertiary academic referral center. J Am Acad Dermatol. 2018;78(2):303-309.e4.
6. Weedon D. The vasculopathic reaction pattern. In: Weedon’s skin pathology. 3rd ed. Edinburgh: Churchill Livingstone/Elsevier; 2010. p. 198-9.
7. Casarin Costa JR, Rodrigues Virgens A, de Oliveira Mestre L, et al. Sweet Syndrome: Clinical Features, Histopathology, and Associations of 83 Cases. J Cutan Med Surg. 2017;21(3):211-216.
8. Trowsdale J, Knight JC. Major histocompatibility complex genomics and human disease. Annu Rev Genomics Hum Genet. 2013. 14: 301-23.
9. Chowell D, Morris LGT, Grigg CM, et al. Patient HLA class I genotype influences cancer response to checkpoint blockade immunotherapy. Science. 2018; 359(6375): 582-587.
10. Takahama H, Kanbe T. Neutrophilic dermatosis of the dorsal hands: a case showing HLA B54, the marker of Sweet's syndrome. Int J Dermatol. 2010;49(9):1079-80.
11. Su W, Liu HN. Diagnostic criteria for Sweet's syndrome. Cutis. 1986; 37(3): 167-174.
12. Von Den Driesch P, et al. Sweet's syndrome (acute febrile neutrophilic dermatosis). J Am Acad Dermatol. 1994;31(4):535-56; quiz 557-60.
13. Khan U, Rizvi H, Ali F, et al. Sweet syndrome: a painful reality. BMJ Case Rep. 2016:2016:bcr2016217606.
14. Cohen PR, Kurzrock R. Sweet's syndrome and cancer. Clin Dermatol, 1993; 11(1): 149-57.
15. Raza S, Kirkland RS, Patel AA, et al. Insight into Sweet's syndrome and associated-malignancy: a review of the current literature. Int J Oncol. 2013;42(5):1516-22.
16. Zheng S, Li SH, Tang SH, et al. Insights Into the Characteristics of Sweet Syndrome in Patients With and Without Hematologic Malignancy. Front Med (Lausanne). 2020:7:20.
17. Kazmi SM, Pemmaraju N, Patel KP, et al. Characteristics of Sweet Syndrome in Patients With Acute Myeloid Leukemia. Clin Lymphoma Myeloma Leuk. 2015;15(6):358-363.
18. El-Khalawany M, Aboeldahab S, , Mosbeh AS, et al. Clinicopathologic, immunophenotyping and cytogenetic analysis of Sweet syndrome in Egyptian patients with acute myeloid leukemia. Pathol Res Pract. 2017;213(2):143-153.
19. Wagner G, Fenchel K, Back W, et al. Leukemia cutis–epidemiology, clinical presentation, and differential diagnoses. J Dtsch Dermatol Ges. 2012;10(1):27-36.
20. Rao AG, Danturty I. Leukemia cutis. Indian J Dermatol. 2012; 57(6): 504.
21. Alderazi A, Rezigh AB. An uncommon culprit of neutropenic fever: a case of Sweet syndrome following induction therapy for acute myeloid leukemia. Arch Clin Cases. 2023;10(4):146-149.
22. Burkeen CG, Pottinger D, Iragavarapu CH, et al. Myocarditis Concurrent with Sweet Syndrome: A Presentation of Acute Myeloid Leukemia. Case Rep Hematol. 2021:2021: 6621007.
23. Paudel A, Dhital R, , Areoye G, et al. Sweet's syndrome in a granulocytopenic patient with acute myeloid leukemia on FLT3 inhibitor. J Community Hosp Intern Med Perspect, 2020; 10(3): 275-278.
24. Cohen PR, Kurzrock R. Sweet’s syndrome: a review of current treatment options. Am J Clin Dermatol. 2002;3(2):117-31.
2. Majed K, et al. SWEET SYNDROME PRESENTS WITH SEVERE SIRS. MedJEM. 2021; (26):19-21.
3. Merola, J., Sweet syndrome (acute febrile neutrophilic dermatosis): Pathogenesis, clinical manifestations, and diagnosis. UpToDate, 2018.
4. Cohen PR. Sweet's syndrome–a comprehensive review of an acute febrile neutrophilic dermatosis. Orphanet J Rare Dis. 2007:2:34.
5. Nelson CA, et al. Sweet syndrome in patients with and without malignancy: a retrospective analysis of 83 patients from a tertiary academic referral center. J Am Acad Dermatol. 2018;78(2):303-309.e4.
6. Weedon D. The vasculopathic reaction pattern. In: Weedon’s skin pathology. 3rd ed. Edinburgh: Churchill Livingstone/Elsevier; 2010. p. 198-9.
7. Casarin Costa JR, Rodrigues Virgens A, de Oliveira Mestre L, et al. Sweet Syndrome: Clinical Features, Histopathology, and Associations of 83 Cases. J Cutan Med Surg. 2017;21(3):211-216.
8. Trowsdale J, Knight JC. Major histocompatibility complex genomics and human disease. Annu Rev Genomics Hum Genet. 2013. 14: 301-23.
9. Chowell D, Morris LGT, Grigg CM, et al. Patient HLA class I genotype influences cancer response to checkpoint blockade immunotherapy. Science. 2018; 359(6375): 582-587.
10. Takahama H, Kanbe T. Neutrophilic dermatosis of the dorsal hands: a case showing HLA B54, the marker of Sweet's syndrome. Int J Dermatol. 2010;49(9):1079-80.
11. Su W, Liu HN. Diagnostic criteria for Sweet's syndrome. Cutis. 1986; 37(3): 167-174.
12. Von Den Driesch P, et al. Sweet's syndrome (acute febrile neutrophilic dermatosis). J Am Acad Dermatol. 1994;31(4):535-56; quiz 557-60.
13. Khan U, Rizvi H, Ali F, et al. Sweet syndrome: a painful reality. BMJ Case Rep. 2016:2016:bcr2016217606.
14. Cohen PR, Kurzrock R. Sweet's syndrome and cancer. Clin Dermatol, 1993; 11(1): 149-57.
15. Raza S, Kirkland RS, Patel AA, et al. Insight into Sweet's syndrome and associated-malignancy: a review of the current literature. Int J Oncol. 2013;42(5):1516-22.
16. Zheng S, Li SH, Tang SH, et al. Insights Into the Characteristics of Sweet Syndrome in Patients With and Without Hematologic Malignancy. Front Med (Lausanne). 2020:7:20.
1. Błaszczyk A, Trojan S, Fussek-Styga U, et al. Sweet Syndrome-A Review of Pathogenesis, Clinical Features, Diagnosis and Treatment. J Educ Health Sport. 2023; 30(1): 45-56.
2. Majed K, et al. SWEET SYNDROME PRESENTS WITH SEVERE SIRS. MedJEM. 2021; (26):19-21.
3. Merola, J., Sweet syndrome (acute febrile neutrophilic dermatosis): Pathogenesis, clinical manifestations, and diagnosis. UpToDate, 2018.
4. Cohen PR. Sweet's syndrome–a comprehensive review of an acute febrile neutrophilic dermatosis. Orphanet J Rare Dis. 2007:2:34.
5. Nelson CA, et al. Sweet syndrome in patients with and without malignancy: a retrospective analysis of 83 patients from a tertiary academic referral center. J Am Acad Dermatol. 2018;78(2):303-309.e4.
6. Weedon D. The vasculopathic reaction pattern. In: Weedon’s skin pathology. 3rd ed. Edinburgh: Churchill Livingstone/Elsevier; 2010. p. 198-9.
7. Casarin Costa JR, Rodrigues Virgens A, de Oliveira Mestre L, et al. Sweet Syndrome: Clinical Features, Histopathology, and Associations of 83 Cases. J Cutan Med Surg. 2017;21(3):211-216.
8. Trowsdale J, Knight JC. Major histocompatibility complex genomics and human disease. Annu Rev Genomics Hum Genet. 2013. 14: 301-23.
9. Chowell D, Morris LGT, Grigg CM, et al. Patient HLA class I genotype influences cancer response to checkpoint blockade immunotherapy. Science. 2018; 359(6375): 582-587.
10. Takahama H, Kanbe T. Neutrophilic dermatosis of the dorsal hands: a case showing HLA B54, the marker of Sweet's syndrome. Int J Dermatol. 2010;49(9):1079-80.
11. Su W, Liu HN. Diagnostic criteria for Sweet's syndrome. Cutis. 1986; 37(3): 167-174.
12. Von Den Driesch P, et al. Sweet's syndrome (acute febrile neutrophilic dermatosis). J Am Acad Dermatol. 1994;31(4):535-56; quiz 557-60.
13. Khan U, Rizvi H, Ali F, et al. Sweet syndrome: a painful reality. BMJ Case Rep. 2016:2016:bcr2016217606.
14. Cohen PR, Kurzrock R. Sweet's syndrome and cancer. Clin Dermatol, 1993; 11(1): 149-57.
15. Raza S, Kirkland RS, Patel AA, et al. Insight into Sweet's syndrome and associated-malignancy: a review of the current literature. Int J Oncol. 2013;42(5):1516-22.
16. Zheng S, Li SH, Tang SH, et al. Insights Into the Characteristics of Sweet Syndrome in Patients With and Without Hematologic Malignancy. Front Med (Lausanne). 2020:7:20.
17. Kazmi SM, Pemmaraju N, Patel KP, et al. Characteristics of Sweet Syndrome in Patients With Acute Myeloid Leukemia. Clin Lymphoma Myeloma Leuk. 2015;15(6):358-363.
18. El-Khalawany M, Aboeldahab S, , Mosbeh AS, et al. Clinicopathologic, immunophenotyping and cytogenetic analysis of Sweet syndrome in Egyptian patients with acute myeloid leukemia. Pathol Res Pract. 2017;213(2):143-153.
19. Wagner G, Fenchel K, Back W, et al. Leukemia cutis–epidemiology, clinical presentation, and differential diagnoses. J Dtsch Dermatol Ges. 2012;10(1):27-36.
20. Rao AG, Danturty I. Leukemia cutis. Indian J Dermatol. 2012; 57(6): 504.
21. Alderazi A, Rezigh AB. An uncommon culprit of neutropenic fever: a case of Sweet syndrome following induction therapy for acute myeloid leukemia. Arch Clin Cases. 2023;10(4):146-149.
22. Burkeen CG, Pottinger D, Iragavarapu CH, et al. Myocarditis Concurrent with Sweet Syndrome: A Presentation of Acute Myeloid Leukemia. Case Rep Hematol. 2021:2021: 6621007.
23. Paudel A, Dhital R, , Areoye G, et al. Sweet's syndrome in a granulocytopenic patient with acute myeloid leukemia on FLT3 inhibitor. J Community Hosp Intern Med Perspect, 2020; 10(3): 275-278.
24. Cohen PR, Kurzrock R. Sweet’s syndrome: a review of current treatment options. Am J Clin Dermatol. 2002;3(2):117-31.
| Files | ||
| Issue | Vol 19 No 3 (2025) | |
| Section | Case Report(s) | |
| Keywords | ||
| Sweet's syndrome; Acute myeloid leukemia; Neutrophil aggregation in the dermis; Case report | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Rezaee A, Vosoughi T, Hosseinzadeh M, Rastegar MH. Sweet’s Syndrome as a Prodromal Manifestation of Acute Myeloid Leukemia. Int J Hematol Oncol Stem Cell Res. 2025;19(3):286-290.
