CASE REPORTS   

Giornale Italiano di Dermatologia e Venereologia 2011 December;146(6):487-92

Copyright © 2011 EDIZIONI MINERVA MEDICA

language: English

Recurrent skin eruption in patient with chronic lymphocytic leukemia and lymphocytic infiltrates of the dermis resembling Sweet’s syndrome

Wawrzycki B. ¹, Chodorowska G. ¹, Pietrzak A. ¹, Krasowska D. ¹, Wąsik Sz. ², Dybiec E. ³, Lotti T. ⁴, Hercegova J. ⁵ ✉

¹ Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland; ² Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin Poland; ³ Department of Pediatric Radiology, Medical University of Lublin, Lublin, Poland; ⁴ Department of Dermatological Sciences, University of Florence, Florence, Italy; ⁵ Department of Dermatology, Second Medical Faculty, Charles University, Prague, Czech Republic

Sweet’s syndrome (acute febrile dermatosis) is characterized by fever, peripheral neutrophil leukocytosis, acute onset of tender erythematous skin lesions (papules, nodules or plaques), and histological findings of a dense infiltrate consisting predominantly of mature neutrophils. Malignancy-associated Sweet’s syndrome constitutes approximately 21% of patients, the majority of whom suffer from hematologic disorder. We report the case of patient with chronic lymphocytic leukemia with recurrent eruptions of tender, pseudovesiculated nodules and plaques with good response to corticosteroid therapy, resembling Sweet’s syndrome. However, histological examination revealed lymphocytic infiltrate in the dermis, which made impossible to establish diagnosis of acute febrile dermatosis according to diagnostic criteria. Association of the skin eruptions with leukemia was implied by improvement of skin lesions after chemotherapy. We present review of the literature reporting cases with atypical histopathological presentations which preceded classical histological appearances, that were mainly associated with hematological malignancies and discuss them in the context of our patient.