A case of recurrent Sweet's syndrome in an 80-year-old man: a clue to an underlying malignancy

International Journal of Dermatology
Hye-Jin ChoiJai-Kyoung Koh

Abstract

An 80-year-old man presented with multiple erythematous papules on the trunk and extremities of a few weeks' duration. He had no past medical or family history of skin diseases or any other medical diseases. A biopsy showed a perivascular lymphohistiocytic infiltrate and sparse neutrophils with several atypical lymphocytes in the deeper dermis. With an initial diagnosis of T-cell pseudolymphoma or unspecified neutrophilic dermatosis, he showed a brisk response to an intramuscular injection of triamcinolone acetonide (40 mg/mL). After 1 month, his skin lesion recurred. Steroid was given with a good clinical response. One month later, however, his skin lesion relapsed. At this time, he presented with disseminated pustulopapular lesions on the trunk and extremities. Examination revealed multiple, variable-sized, erythematous plaques with central pustules on the extremities (Fig. 1). The mucous membranes were not involved. He had no pain or tenderness. He had no systemic symptoms. Laboratory tests showed a hemoglobin level of 10.3 g/dL, a leukocyte level of 6,900/mm(3), with an increased proportion of segmented nuclear neutrophils (83%), and an elevated C-reactive protein. A skin biopsy revealed a dense perivascular and interstitia...Continue Reading

References

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Jun 1, 1987·The American Journal of Medicine·P R Cohen, R Kurzrock
Oct 1, 1994·Journal of the American Academy of Dermatology·P von den Driesch
Dec 9, 1997·The British Journal of Dermatology·J F BourkeR A Graham-Brown
Aug 8, 2001·Clinical and Experimental Dermatology·J Vázquez GarcíaE Fonseca Capdevila
Jan 25, 2002·Journal of the American Academy of Dermatology·Jens GilleRoland Kaufmann
Aug 1, 1964·The British Journal of Dermatology·R D SWEET
Oct 3, 2003·International Journal of Dermatology·Philip R Cohen, Razelle Kurzrock

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