When the Skin Speaks for the Bone Marrow: Sweet Syndrome and Pancytopenia as the Initial Manifestation of Occult AML
-
Sohrab Aghabeigi
,
Nooshin Ahmadvand
,
Seyedeh Mohadese Mosavi Mirkalaie
,
Azadeh Sedighi Moghadam
,
Arefeh Aref-Eshghi
Abstract
This case report describes the presentation for a 65-year-old patient with Sweet's syndrome (SS) presenting with systemic symptoms of general weakness, fever, and painful skin lesions on the right arm. He reported a history of weight loss with night sweats, while skin lesions manifested as erythematous plaques and painful papules. The diagnosis was confirmed by skin biopsy, which showed features of significant neutrophilic infiltrations on histopathology. Further investigations led to the diagnosis of AML associated with Sweet's syndrome. The study highlights the importance of prompt diagnosis of Sweet's syndrome as a paraneoplastic sign and using multi-disciplinary approach for diagnosis and management of patients with skin lesions and cytopenias.
1. Villarreal-Villarreal CD, Ocampo-Candiani J, Villarreal-Martínez A. Sweet Syndrome: A Review and Update. Actas Dermosifiliogr. 2016;107(5):369-78
2. Heath MS, Ortega-Loayza AG. Insights Into the Pathogenesis of Sweet's Syndrome. Front Immunol. 2019;10:414.
3. Vashisht P, Goyal A, Hearth Holmes MP. Sweet Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-[Updated 2023 Aug 8]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK431050/
4. Corazza M, Lauriola MM, Borghi A, et al. Sweet's syndrome: a retrospective clinical, histopathological and immunohistochemical analysis of 11 cases. Acta Derm Venereol. 2008;88(6):601-6.
5. Sweet R. An acute neutrophilic dermatosis. Br J Dermatol.1964; 76:349-56.
6. Von Den Driesch P. Sweet's syndrome (acute febrile neutrophilic dermatosis). J Am Acad Dermatol. 1994;31(4):535-56; quiz 557-60.
7. Cohen PR, Kurzrock R. Sweet's syndrome and malignancy. Am J Med. 1987;82(6):1220-6.
8. Vashisht P, Goyal A, Hearth Holmes MP. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan. Available from: https://pubmed.ncbi.nlm.nih.gov/28613704/
9. Cohen PR. Sweet's syndrome--a comprehensive review of an acute febrile neutrophilic dermatosis. Orphanet J Rare Dis. 2007;2:34.
10. Paydas S. Sweet's syndrome: a revisit for hematologists and oncologists. Crit Rev Oncol Hematol. 2013;86(1):85-95.
11. Cohen PR, Kurzrock R. Sweet's syndrome and cancer and cancer. Clin Dermatol. 1993;11(1):149-57.
12. Cohen PR, Talpaz M, Kurzrock R. Malignancy-associated Sweet's syndrome: review of the world literature. J Clin Oncol. 1988;6(12):1887-97.
13. Haverstock C, Libecco JF, Sadeghi P, et al. Tender Erythematous Plaques in a Woman With Acute Myelogenous Leukemia—Quiz Case. Arch Dermatol. 2006;142(2):235-40.
14. Disel U, Paydas S, Yavuz S, et al. Bilateral ear Sweet's syndrome in a case with relapse acute myeloblastic leukemia. Leuk Res. 2006;30(3):364.
15. Rochet NM, Chavan RN, Cappel MA, et al. Sweet syndrome: clinical presentation, associations, and response to treatment in 77 patients. J Am Acad Dermatol. 2013;69(4):557-64.
16. Casarin Costa JR, Virgens AR, de Oliveira Mestre L, et al. Sweet syndrome: clinical features, histopathology, and associations of 83 cases. J Cutan Med Surg. 2017;21(3):211-6.
17. Zheng S, Li S, Tang S, et al. Insights Into the Characteristics of Sweet Syndrome in Patients With and Without Hematologic Malignancy. Front Med (Lausanne). 2020:7:20.
18. 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):358-63.
19. Alegría-Landa V, Rodríguez-Pinilla SM, Santos-Briz A, et al. Clinicopathologic, Immunohistochemical, and Molecular Features of Histiocytoid Sweet Syndrome. JAMA Dermatol. 2017;153(7):651-9.
20. 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):143-53.
2. Heath MS, Ortega-Loayza AG. Insights Into the Pathogenesis of Sweet's Syndrome. Front Immunol. 2019;10:414.
3. Vashisht P, Goyal A, Hearth Holmes MP. Sweet Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-[Updated 2023 Aug 8]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK431050/
4. Corazza M, Lauriola MM, Borghi A, et al. Sweet's syndrome: a retrospective clinical, histopathological and immunohistochemical analysis of 11 cases. Acta Derm Venereol. 2008;88(6):601-6.
5. Sweet R. An acute neutrophilic dermatosis. Br J Dermatol.1964; 76:349-56.
6. Von Den Driesch P. Sweet's syndrome (acute febrile neutrophilic dermatosis). J Am Acad Dermatol. 1994;31(4):535-56; quiz 557-60.
7. Cohen PR, Kurzrock R. Sweet's syndrome and malignancy. Am J Med. 1987;82(6):1220-6.
8. Vashisht P, Goyal A, Hearth Holmes MP. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan. Available from: https://pubmed.ncbi.nlm.nih.gov/28613704/
9. Cohen PR. Sweet's syndrome--a comprehensive review of an acute febrile neutrophilic dermatosis. Orphanet J Rare Dis. 2007;2:34.
10. Paydas S. Sweet's syndrome: a revisit for hematologists and oncologists. Crit Rev Oncol Hematol. 2013;86(1):85-95.
11. Cohen PR, Kurzrock R. Sweet's syndrome and cancer and cancer. Clin Dermatol. 1993;11(1):149-57.
12. Cohen PR, Talpaz M, Kurzrock R. Malignancy-associated Sweet's syndrome: review of the world literature. J Clin Oncol. 1988;6(12):1887-97.
13. Haverstock C, Libecco JF, Sadeghi P, et al. Tender Erythematous Plaques in a Woman With Acute Myelogenous Leukemia—Quiz Case. Arch Dermatol. 2006;142(2):235-40.
14. Disel U, Paydas S, Yavuz S, et al. Bilateral ear Sweet's syndrome in a case with relapse acute myeloblastic leukemia. Leuk Res. 2006;30(3):364.
15. Rochet NM, Chavan RN, Cappel MA, et al. Sweet syndrome: clinical presentation, associations, and response to treatment in 77 patients. J Am Acad Dermatol. 2013;69(4):557-64.
16. Casarin Costa JR, Virgens AR, de Oliveira Mestre L, et al. Sweet syndrome: clinical features, histopathology, and associations of 83 cases. J Cutan Med Surg. 2017;21(3):211-6.
17. Zheng S, Li S, Tang S, et al. Insights Into the Characteristics of Sweet Syndrome in Patients With and Without Hematologic Malignancy. Front Med (Lausanne). 2020:7:20.
18. 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):358-63.
19. Alegría-Landa V, Rodríguez-Pinilla SM, Santos-Briz A, et al. Clinicopathologic, Immunohistochemical, and Molecular Features of Histiocytoid Sweet Syndrome. JAMA Dermatol. 2017;153(7):651-9.
20. 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):143-53.
| Files | ||
| Issue | Vol 20 No 1 (2026): Articles In Press | |
| Section | Case Report(s) | |
| Keywords | ||
| Sweet syndrome AML paraneoplastic | ||
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How to Cite
1.
Aghabeigi S, Ahmadvand N, Mosavi Mirkalaie SM, Sedighi Moghadam A, Aref-Eshghi A. When the Skin Speaks for the Bone Marrow: Sweet Syndrome and Pancytopenia as the Initial Manifestation of Occult AML. Int J Hematol Oncol Stem Cell Res. 2026;20(1).
