Sweet syndrome Flashcards
■ An uncommon, acute, and recurrent, cytokine-induced skin reaction associated with various etiologies.
■ Pain ul plaque- orming in ammatory papules, o ten with massive exudations giving the appearance
o vesiculation (pseudovesiculation).
■ Accompanied by ever, arthralgia, and peripheral leukocytosis
sweet syndrome
age gender etio
AGEOFONSET Mostofen30to60years.
SEX Women > men.
ETIOLOGY Unknown, possibly hypersensitivity reaction. It belongs to the group o neutrophilic dermatoses and possibly to the spectrum o autoin ammatorydiseases.
mucosal lesions
MUCOUSMEMBRANES ± Conjunctivitis, episcleritis.
most common areas
Most common on
ace (Fig. 7-6A), neck (Fig. 7-6B), and upper extremities but also on lower extremities, where lesionsmaybedeepinthe atandthusmimic panniculitis
ahat causes the alpearance of pseudo vesiculation
Pseudovesiculation: Intense edemagivestheappearanceo vesiculation
skin lesions
Prodromesare ebrileupperrespiratorytract in ections. Gastrointestinal symptoms (diar- rhea),tonsillitis,in uenza-likeillness,1to
3 weeks be ore skin lesions. Lesions tender/ pain ul. Fever (not always present), headache, arthralgia, and general malaise.
SKINLESIONS Brightred,smooth,tenderpapules (2to4mmindiameter)thatcoalesceto orm irregular,sharplybordered,in ammatory plaques (Fig. 7-6A). Pseudovesiculation
cbc resulta
COMPLETEBLOOD COUNT Leukocytosis with neutrophilia (not always present).
ESR Elevated.
DP
Diagnostic. Epidermis usually normal, sometimes subcorneal pustula- tion. Massive edema o papillary body, dense leukocytic in ltrate with starburst pattern in mid-dermis, consisting o neutrophils with occasional eosinophils/lymphoid cells. Leuko- cytoclasia, nuclear dust, but no vasculitis. ± Neutrophilic in ltrates in subcutaneous tissue.
tx
Rule out sepsis.
PREDNISONE 30 to 50 mg/d, tapering in 2 to 3weekslesionsresolvewithina ewdays
ANTIBIOTICTHERAPY Clears eruption in Yersinia-
