SWEETS-SYNDROME WITHOUT GRANULOCYTOSIS

Background Sweet's syndrome (SS), acute febrile neutrophilic dermatosi s, has been linked to hematologic malignancies and presents with chara cteristic edematous dermal plaques. Peripheral blood neutrophilia is f requently seen in association with SS and is one of the diagnostic cri teria. Objective To report the clinical, laboratory, and hematologic d ata of four patients with myeloid leukemia who developed SS after chem otherapy. Three of these patients were neutropenic. Methods A retrospe ctive study of four patients with SS and hematologic malignancies was undertaken. Three patients had de novo acute myelogenous leukemia and one was in the acute blast crisis of chronic myelogenous leukemia. Res ults Sweet's syndrome was not originally suspected in these patients b ecause of the low peripheral white blood cell counts caused by chemoth erapy. All of the patients presented with fevers, arthralgias, and an eruption. They had been treated with antibiotics because of a presumed infection. Once the correct diagnosis was made and oral prednisolone was started, a rapid response followed. Conclusions Sweet's syndrome s hould be considered in the differential diagnosis when acute myeloid l eukemic patients develop skin lesions and unexplained fevers regardles s of the peripheral blood counts.