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Sweet's panniculitis.

J Cullity1, B Maguire, K Gebauer

  • 1Department of Haematology, Fremantle Hospital, Western Australia.

The Australasian Journal of Dermatology
|January 1, 1991
PubMed
Summary
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A 65-year-old female with Myelodysplastic Syndrome transforming to Acute Myeloid Leukaemia developed Sweet's syndrome. The condition, characterized by skin plaques, responded well to systemic steroids.

Area of Science:

  • Dermatology
  • Hematology
  • Oncology

Background:

  • Myelodysplastic Syndrome (MDS) is a group of clonal hematopoietic stem cell disorders.
  • Transformation of MDS to Acute Myeloid Leukaemia (AML) is a critical progression.
  • Sweet's syndrome, an uncommon neutrophilic dermatosis, can be associated with hematologic malignancies.

Observation:

  • A 65-year-old female patient with MDS transforming to AML presented with acute, tender, erythematous plaques.
  • The clinical presentation was highly suggestive of Sweet's syndrome.
  • Histopathological examination revealed normal epidermis, dermal and subcutaneous edema, and significant polymorphonuclear cell infiltration in the panniculus.

Findings:

  • The patient's skin eruption showed a rapid positive response to systemic corticosteroid therapy.

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  • A recurrence of symptoms (recrudescence) was observed upon reduction of the steroid dosage.
  • Sustained symptom remission was achieved with a slower tapering of prednisolone dosage.

    • Implications:

    • This case highlights the association between Sweet's syndrome and the transformation of MDS to AML.
    • Prompt recognition and management of Sweet's syndrome are crucial in patients with hematologic malignancies.
    • Systemic corticosteroids are an effective treatment for Sweet's syndrome, with careful dose titration necessary to prevent relapse.