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Drug-induced Sweet's syndrome after mitoxantrone therapy in a patient with multiple sclerosis

T Kümpfel1, L A Gerdes, M Flaig

  • 1Institute of Clinical Neuroimmunology, Ludwig-Maximilians-University, Munich, Germany.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|December 15, 2010
PubMed

Insights

A patient with multiple sclerosis developed Sweet's syndrome, a rare skin condition, after mitoxantrone treatment. Prompt corticosteroid therapy resolved the symptoms, highlighting a potential adverse effect of this chemotherapy.

Area of Science:

  • Dermatology
  • Oncology
  • Neurology

Background:

  • Mitoxantrone is an antineoplastic agent used in treating certain cancers and multiple sclerosis.
  • Secondary progressive multiple sclerosis (SPMS) is a disabling neurological condition.
  • Sweet's syndrome, or acute febrile neutrophilic dermatosis, is characterized by fever and skin lesions.

Observation:

  • A 55-year-old male patient with SPMS presented with fever, neutrophilia, and painful skin lesions after mitoxantrone infusion.
  • Differential diagnoses including infections and rheumatological conditions were excluded.
  • Skin biopsy revealed neutrophilic infiltrates, confirming Sweet's syndrome.

Findings:

  • This case represents the first documented instance of Sweet's syndrome occurring subsequent to mitoxantrone therapy.
  • The patient experienced rapid improvement in both systemic and cutaneous symptoms upon initiation of oral corticosteroids.
  • Skin biopsy was crucial in differentiating Sweet's syndrome from other potential dermatological conditions.

Implications:

  • Clinicians should consider Sweet's syndrome in patients presenting with unexplained fever and rash during mitoxantrone treatment.
  • Awareness of this potential adverse effect can lead to timely diagnosis and management.
  • This finding expands the known spectrum of mitoxantrone-associated dermatological reactions.

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