Diazepam‐associated Sweet's syndrome

Guimerá, Francisco; García‐Bustínduy, M.; Noda, Antonio Sedeño; Sáez, Miguel; Dorta, S.; Sánchez, Rosalba; Martín‐Herrera, Antonio; García‐Montelongo, R.

doi:10.1046/j.1365-4362.2000.00051.x

“…The implicated medications were trimethoprim–sulphamethoxazole 1,2 (two subjects), ethinyl oestradiol and levonorgestrel 3 (one subject), minocycline 4 (two subjects), all‐ trans ‐retinoic acid 5 (seven subjects), granulocyte colony‐stimulating factor 6 (30 subjects), hydralazine 7 (two subjects), diclofenac 8 (one subject), carbamazepine 9 (one subject) and nitrofurantoin 10 (one subject). In addition we reported the first known case of diazepam‐induced Sweet's syndrome 11 and the second case of Sweet's syndrome associated with an oral contraceptive containing ethinyl oestradiol and gestodene 12 . The age of the subjects with drug‐induced Sweet's syndrome ranged from 5 to 75 years (mean age, 47 years), and the majority were women (32 of 49).…”

mentioning

confidence: 98%

Drug‐induced Sweet's syndrome

Sáez

¹

,

García‐Bustínduy

²

,

Noda

³

et al. 2004

Acad Dermatol Venereol

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Laugier-Hunziker syndrome (LHS) is a rare disorder characterized by melanotic pigmentation of the mouth and lips which is frequently associated with longitudinal melanonychia. Laugier and Hunziker described lenticular melanotic pigmentation of the oral cavity and lips in 1970. 1 Some cases have been described in which the neck, thorax, abdomen, fingers and soles have been involved. Fingernails are more frequently involved than the toenails. 2 Melanonychia may also be seen with or after lichen planus (LP). 3,4 We report a case of LHS associated with actinic LP.A 37-year-old Turkish woman was referred to our clinic with melanotic macules on the face, a pruritic annular plaque on the malar area of her face and hyperpigmented streaks on her nails, which had appeared for 19 years, 10 months and 6 years, respectively.Examination revealed the patient's pigmented macules on the lips, gums, buccal mucosa and midline of the hard palate ( fig. 1a). There were melasma and pinkish annular plaque, with a hyperpigmented centre ( fig. 1b). There were longitudinal melanonychia on her fingernails ( fig. 1c) and toenails. Hyperpigmented slate-grey to brown macular lesions were seen over her back. Examination of intertriginous areas did not reveal any evidence of acanthosis nigiricans. The skin phototype according to Fitzpatrick's scale was IV.Results of routine laboratory tests were within normal ranges, including triiodothyronine (T3), thyroxine (T4) and thyrotropin (TSH). The patient had smoked for 20 years. Her mother had melasma. Histopathological examination of pigmented macula on the buccal mucosa showed an accumulation of melanin in the cells of the basal layer of the acanthotic epidermis and an increased number of melanophages in the upper dermis ( fig. 2). Histopathologically, there was thinning of the epidermis with vacuolar alteration of the basal layer, an artifactural cleft between the epidermis and the lichenoid infiltrate and pigment incontinence in the upper dermis on the annular lesion over the cheek (fig. 3).Since the first description by Laugier and Hunziker, many cases of LHS have been reported. 2,[5][6][7] In this syndrome, the essential lesions are manifested as lenticular-pigmented macules, which have different colours (from grey to brown to blueblack) and a smooth surface. Generally symptoms are absent. The most common sites are the lips (especially the lower lip) and the oral cavity (buccal mucosa and hard palate). Other sites such as labial comissure, the gums the floor of the mouth and the tongue are less frequent. Other locations such as the abdomen and the fingers have been involved. Fingernail involvement can present as a single longitudinal 1-2-mm-wide streak or as a double 2-3-mm-wide longitudinal streak on the lateral parts of the nail plate, as a homogeneous pigmentation of the radial or ulnar half of the nail, and complete pigmentation of the nail. All four types of nail involvement may simultaneously involve one or more nails of the fingers and /or toes. 2 fig. 1 (a) Multiple pigmented macules lo...

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“…Azzopardi and Eusebi found melanin pigment in 14 of 20 patients with breast carcinoma metastases with epidermotropism. 11 However, they found no pigmentation in 20 tumours that did not infiltrate as far as the epidermis. Thus, they concluded that melanin pigment is frequent in breast carcinoma with epidermotropism, but selective staining for melanin is usually needed to detect the pigmentation.…”

Section: Figmentioning

confidence: 95%

“…The implicated medications were trimethoprim-sulphamethoxazole 1,2 (two subjects), ethinyl oestradiol and levonorgestrel 3 (one subject), minocycline 4 (two subjects), all-trans-retinoic acid 5 (seven subjects), granulocyte colony-stimulating factor 6 (30 subjects), hydralazine 7 (two subjects), diclofenac 8 (one subject), carbamazepine 9 (one subject) and nitrofurantoin 10 (one subject). In addition we reported the first known case of diazepam-induced Sweet's syndrome 11 and the second case of Sweet's syndrome associated with an oral contraceptive containing ethinyl oestradiol and gestodene. 12 The age of the subjects with drug-induced Sweet's syndrome ranged from 5 to 75 years (mean age, 47 years), and the majority were women (32 of 49).…”

Section: Drug-induced Sweet's Syndromementioning

confidence: 96%

Topical Cidofovir and Cryotherapy – combination treatment for recalcitrant molluscum contagiosum in a patient with HIV infection

Baxter

¹

,

Highet

²

2004

Acad Dermatol Venereol

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Laugier-Hunziker syndrome (LHS) is a rare disorder characterized by melanotic pigmentation of the mouth and lips which is frequently associated with longitudinal melanonychia. Laugier and Hunziker described lenticular melanotic pigmentation of the oral cavity and lips in 1970. 1 Some cases have been described in which the neck, thorax, abdomen, fingers and soles have been involved. Fingernails are more frequently involved than the toenails. 2 Melanonychia may also be seen with or after lichen planus (LP). 3,4 We report a case of LHS associated with actinic LP.A 37-year-old Turkish woman was referred to our clinic with melanotic macules on the face, a pruritic annular plaque on the malar area of her face and hyperpigmented streaks on her nails, which had appeared for 19 years, 10 months and 6 years, respectively.Examination revealed the patient's pigmented macules on the lips, gums, buccal mucosa and midline of the hard palate ( fig. 1a). There were melasma and pinkish annular plaque, with a hyperpigmented centre ( fig. 1b). There were longitudinal melanonychia on her fingernails ( fig. 1c) and toenails. Hyperpigmented slate-grey to brown macular lesions were seen over her back. Examination of intertriginous areas did not reveal any evidence of acanthosis nigiricans. The skin phototype according to Fitzpatrick's scale was IV.Results of routine laboratory tests were within normal ranges, including triiodothyronine (T3), thyroxine (T4) and thyrotropin (TSH). The patient had smoked for 20 years. Her mother had melasma. Histopathological examination of pigmented macula on the buccal mucosa showed an accumulation of melanin in the cells of the basal layer of the acanthotic epidermis and an increased number of melanophages in the upper dermis ( fig. 2). Histopathologically, there was thinning of the epidermis with vacuolar alteration of the basal layer, an artifactural cleft between the epidermis and the lichenoid infiltrate and pigment incontinence in the upper dermis on the annular lesion over the cheek (fig. 3).Since the first description by Laugier and Hunziker, many cases of LHS have been reported. 2,[5][6][7] In this syndrome, the essential lesions are manifested as lenticular-pigmented macules, which have different colours (from grey to brown to blueblack) and a smooth surface. Generally symptoms are absent. The most common sites are the lips (especially the lower lip) and the oral cavity (buccal mucosa and hard palate). Other sites such as labial comissure, the gums the floor of the mouth and the tongue are less frequent. Other locations such as the abdomen and the fingers have been involved. Fingernail involvement can present as a single longitudinal 1-2-mm-wide streak or as a double 2-3-mm-wide longitudinal streak on the lateral parts of the nail plate, as a homogeneous pigmentation of the radial or ulnar half of the nail, and complete pigmentation of the nail. All four types of nail involvement may simultaneously involve one or more nails of the fingers and /or toes. 2 fig. 1 (a) Multiple pigmented macules lo...

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“…The drug-induced variant of Sweet's syndrome is most frequently observed following administration of granulocyte-colony stimulating factor (G-CSF) [3,4]. Other commonly used drugs reported to cause Sweet's syndrome are antibiotics such as trimethoprimsulfamethoxazole [5], nitrofurantoin [6], antiepileptic drugs such as carbamazepine [7], diazepam [8], diuretics such as furosemide [9], non-steroidal antiinflammatory drugs such as diclofenac [10], and celecoxib [11]. Sweet's syndrome has also been reported following infections of the upper respiratory tract [12,13] and the gastrointestinal tract [14].…”

Section: Introductionmentioning

confidence: 99%

Sweet’s syndrome: a very rare association with pulmonary tuberculosis

Karmakar

¹

,

Sherpa

²

,

Ray

³

et al. 2013

J Infect Dev Ctries

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Mycobacterium tuberculosis infection is a common infection in developing countries, including India. It can induce several cutaneous reactions such as erythema nodosum, and erythema induratum; however, association of tuberculosis with Sweet's syndrome (also known as acute febrile neutrophilic dermatosis) is extremely rare. Here we present an interesting case of sputum-positive pulmonary tuberculosis with Sweet's syndrome. A 55-year-old female who was receiving a regimen of four antitubercular drugs (isoniazid, rifampicin, pyrazinamide, ethambutol-HRZE) for six weeks for sputum-positive pulmonary tuberculosis developed new onset high-grade fever for 15 days along with multiple reddish brown plaques and nodules involving the face as well as all four limbs of the body. Histopathology of the skin lesion was suggestive of Sweet's syndrome. The patient responded well to immunosuppressive steroid therapy.

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Diazepam‐associated Sweet's syndrome

Cited by 31 publications

References 20 publications

Drug‐induced Sweet's syndrome

Drug‐induced Sweet's syndrome

Topical Cidofovir and Cryotherapy – combination treatment for recalcitrant molluscum contagiosum in a patient with HIV infection

Sweet’s syndrome: a very rare association with pulmonary tuberculosis

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