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Neutrophilic Dermatosis of the Hands: A Case Report.

Acta Dermatovenerol Croat

December 2023

Nooshin Bagherani, MD, PhD, Tehran University of Medical Sciences, Italy Street, Tehran, Iran;

Article Synopsis
  • - Neutrophilic dermatosis of the hands (NDDH) is a recently identified localized variant of Sweet's syndrome, characterized by violaceous papulonodules on the hands, lacking true vasculitis findings, as outlined by Strutton et al. (1996) and Galaria et al. (2000).
  • - A 46-year-old man presented with a painful, ulcerative lesion on his left hand, which started as a small papule and progressively worsened despite various treatments for suspected bacterial or fungal infections.
  • - Upon examination, the lesion measured 4×7 cm and was associated with atrophic scars from previous similar lesions; laboratory tests indicated leukocytosis and altered liver function
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Sweet's syndrome (SS), or acute febrile neutrophilic dermatosis, characteristically presents with fever, dermal neutrophilic infiltrates, and neutrophilia. It typically manifests as tender erythematous plaques; however, various variants are documented, including bullous. Malignancy-associated Sweet's syndrome (MASS) can present as a paraneoplastic syndrome in those with established cancers or with undiagnosed malignancies.

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Paraneoplastic autoimmune and inflammatory disorders are often associated with myelodysplastic syndromes (MDS). The etiopathogenesis of MDS-associated autoimmune and inflammatory disorders is still unclear and treatment options are limited. Patients with MDS are at high risk of infections, which can be increased by the use of steroids.

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The Sweet's syndrome, is an inflammatory skin disorder characterized by extensive infiltration of neutrophils in the dermis with extension to the subcutis, known as acute febrile neutrophilic dermatosis. It may occur as a paraneoplastic syndrome. To our knowledge, there are currently few reports about transformation of a myelodysplastic syndrome to acute myeloid leukemia and concurrent necrotizing Sweet syndrome in the literature.

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Neuro-Sweet syndrome - a rare differential diagnosis in aseptic meningoencephalitis.

Neurol Res Pract

November 2019

Department of Epileptology, University Hospital for Neurology, Eberhard Karls University, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany.

Acute febrile neutrophilic dermatosis (Sweet's syndrome) is a dermatological entity, which may be associated with malignancies, drugs, and infections and which is characterized by high fever, elevated neutrophils, and tender erythematous skin lesions. Involvement of the nervous system - Neuro-Sweet syndrome (NSS) - is rare, manifesting most commonly with an encephalitic syndrome in addition to fever and dermal lesions. Here, we report an unusual case of NSS in a Caucasian male patient in the setting of B-cell-lymphocytosis, with encephalitis preceding dermal lesions.

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