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Lymphocytes in Sweet syndrome: A potential diagnostic pitfall
Viktoryia Kazlouskaya1, Jacqueline M Junkins-Hopkins2
1Department of Dermatology, SUNY Downstate Medical Center, New York, New York.
Sweet syndrome (SS) biopsies reveal a significant lymphocytic infiltrate, often exceeding neutrophils. Recognizing this lymphocyte presence is crucial for accurate SS diagnosis, especially in subcutaneous lesions.
Area of Science:
- Dermatology
- Immunohistopathology
Background:
- Sweet syndrome (SS) is characterized by neutrophilic infiltrates in skin lesions.
- Lymphocytes are also present but often overlooked in SS histopathology.
Purpose of the Study:
- To investigate the cellular infiltrate, particularly lymphocytes, in Sweet syndrome biopsies.
- To assess the diagnostic implications of the lymphocytic component in SS.
Main Methods:
- Analysis of 9 SS lesion biopsies using routine staining and immunohistochemistry.
- Immunophenotyping of lymphocytes using CD markers (CD3, CD4, CD8).
Main Results:
- Lymphocytes were found in all SS biopsies, sometimes outnumbering neutrophils.
- Neutrophil fragmentation can lead to misinterpretation as lymphocyte-rich.
- Immunohistochemistry confirmed CD3+, CD4+, CD20(-) lymphocytes, with rare CD8+ cells.
Conclusions:
- The lymphocytic component in SS is significant and must be recognized to prevent diagnostic errors.
- Distinguishing SS from neutrophilic urticarial dermatosis may be aided by identifying this lymphocytic infiltrate.
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