Acute Febrile Neutrophilic Dermatosis

Acute febrile neutrophilic dermatosis (Sweet syndrome) occurs in close association with hematological and lymphoproliferative disorders (9,10). Paraneoplastic Sweet syndrome is most often associated with acute myeloid leukemia (11). However, some cases may be induced by retinoic acid used for treatment of leukemia (12). Clinically,

Figure 1 Erythema gyratum repens: concentric expanding rings on the trunk.

Sweet syndrome is characterized by painful erythematous plaques on the face, extremities and the trunk (Fig. 3). In addition, patients are febrile and suffer from malaise. Laboratory examination reveals an elevated neutrophil count. Histologi-cally, a diffuse heavy infiltrate of neutrophils extending through the entire dermis is the hallmark of the lesion. Subepidermal edema can lead to blister formation. Additional findings may include erythrocyte extravasation, mild leukocytoklasia, and presence of lymphocytes and a few eosinophils. The differential diagnosis includes vasculitis secondary to leukemia as well as leukemia cutis in chronic neutro-philic leukemia (13,14).

Figure 2 Paraneoplastic pityriasis lichenoides et varioliformis acuta (PLEVA): disseminated eroded scaly papules in a patient with MF.

Figure 3 Sweet syndrome: infiltrated plaques on the back in patient with acute myeloid leukemia.

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How To Deal With Rosacea and Eczema

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