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Sweet's syndrome without granulocytosis

C Probert¹, W C Ehmann, H al-Mondhiry

¹Pennsylvania State University College of Medicine, USA.

International Journal of Dermatology

|May 16, 1998

Summary

Sweet's syndrome (SS) can occur in acute myeloid leukemia patients post-chemotherapy, even with low white blood cell counts. Early diagnosis and treatment with prednisolone are crucial for rapid recovery.

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Area of Science:

Hematology
Dermatology
Oncology

Background:

Sweet's syndrome (SS), or acute febrile neutrophilic dermatosis, is associated with hematologic malignancies and presents with edematous dermal plaques.
Peripheral blood neutrophilia is a common diagnostic criterion for SS.

Observation:

Four patients with myeloid leukemia developed SS following chemotherapy; three were neutropenic.
SS was initially overlooked due to chemotherapy-induced low white blood cell counts.
Patients presented with fever, arthralgias, and skin eruption, initially treated as infection.

Findings:

Despite neutropenia, all patients responded rapidly to oral prednisolone after SS diagnosis.
Diagnosis of SS was confirmed retrospectively in these four myeloid leukemia patients.

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Implications:

Consider SS in acute myeloid leukemia patients with skin lesions and fever, irrespective of peripheral blood counts.
Prompt diagnosis and corticosteroid treatment are vital for managing SS in leukemia patients.