Extracutaneous neutrophilic inflammation in a dog with lesions resembling Sweet's Syndrome

A 7-year-old-spayed female standard poodle dog presented to the Iowa State University Veterinary Teaching Hospital with an 8-day history of lethargy, left hind limb lameness, ptyalism and peripheral lymphadenomegaly. On physical examination, the dog was lethargic, febrile (40.5 degrees C) and had multifocal to coalescing erythematous papular to pustular eruptions on the skin of all four limbs, periocularly and on the ventral and lateral thorax and abdomen. Histopathological findings from skin biopsies of the papules revealed a severe diffuse neutrophilic dermatitis with sub- and intra-epithelial pustules. Four days after being admitted the dog died from cardiac and respiratory failure. At necropsy, in addition to the multifocal to coalescing erythematous papules, the skin contained scattered pustules. Additionally, the subcutaneous tissue surrounding the right stifle was diffusely oedematous, and the peripheral and visceral lymph nodes were enlarged. The predominant histologic lesion was neutrophilic inflammation, in the absence of detectable bacteria in the skin, heart, lungs, oesophagus and left tarsus. In the absence of neoplasia or bacteraemia, a syndrome similar to Sweet's Syndrome should be considered as a differential diagnosis in dogs with cutaneous and extracutaneous neutrophilic infiltrates.