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A Sweet Diagnosis for a Non-Resolving Rash
Jian Liang Tan1, Kah Poh Loh2, Kshitij Thakur1
1Internal Medicine, Crozer-Chester Medical Center, Upland, USA.
Cureus
|June 27, 2018
Summary
Subcutaneous Sweet's syndrome (SSS) is a rare condition presenting as skin nodules. Early diagnosis in myelodysplastic syndrome (MDS) patients is key to avoid prolonged antibiotics.
Area of Science:
- Dermatology
- Hematology
- Pathology
Background:
- Subcutaneous Sweet's syndrome (SSS) is a rare neutrophilic dermatosis.
- It is characterized by erythematous plaques or nodules and neutrophilic panniculitis (NP).
Observation:
- A 74-year-old woman with myelodysplastic syndrome (MDS) presented with persistent fever, malaise, and generalized erythematous nodules.
- The patient's condition was diagnosed as MDS-related SSS.
Findings:
- SSS diagnosis requires excluding other causes of NP before corticosteroid treatment.
- Prompt SSS identification in non-responsive antibiotic cases is crucial for antimicrobial stewardship.
Implications:
- Early SSS diagnosis in MDS patients can prevent prolonged antibiotic exposure.
- A slow corticosteroid taper may benefit patients experiencing frequent SSS relapses.
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