Sweet's syndrome after splenic irradiation for chronic myelogenous leukemia

Abstract

Sweet's syndrome is defined as acute febrile neutrophilic dermatosis. Characteristic features are fever; peripheral neutrophilia; and painful cutaneous nodules and plaques on the face, neck, trunk, and limbs. Biopsy specimens of these lesions show a mature neutrophilic infiltrate of the dermis. Vasculitis is absent. Sweet's syndrome is associated with malignancy in approximately 20% of reported cases. The pathogenesis is unknown. The authors describe Sweet's syndrome in a 39year-old man 5 weeks after splenic irradiation for chronic myelogenous leukemia. Treatment with parenteral corticosteroids resulted in dramatic improvement of the patient's condition. The authors discuss the diagnosis of Sweet's syndrome and the fact that it is thought to be cytokine-induced.

Sweet syndrome in a field of radiation therapy

“…3 Topical or oral corticosteroids lead to resolution in most cases, but interruption of radiation may be necessary. 1,4 Our patient's presentation is most consistent with a diagnosis of Sweet syndrome associated with radiation, as evidenced by the concentration of the rash in the irradiated field, rapid response to treatment with topical corticosteroids, and no symptom recurrence after discontinuing radiation therapy. Because our patient later developed lung metastases, we cannot exclude the possibility that occult tumor induced his lesions.…”

“…[1][2][3][4][5] As in our case, previous reports describe the initiation of the rash within the radiation field, followed by spread to nonirradiated fields. Given the diverse etiologic associations, the mechanism of action has not been determined.…”

“…[1][2][3][4] Sorafenib, the multikinase inhibitor, has been reported to cause a variety of cutaneous manifestations ranging from erythema multiforme to lesions resembling chloracne. 5 Although most reports focus on the development of multiple squamous cell carcinomas and other squamous lesions, some discuss the development of follicular hyperplasia and ectatic follicular infundibula.…”

Hyperfunction of neutrophils in a patient with BCR/ABL negative chronic myeloid leukemia

“…Urano et al 23 1999 CML (1) SS Probert et al 24 1998 CML (1) SS Pertusi et al 25 1996 CML (1) SS Kannan et al 26 1995 CML (1) SS Brodkin and Schwartz 27 1995 CML (1) SS Dieguez et al 28 1993 CML (1) SS Torri et al 29 1993 CML (1) SS Feliu et al 30 1992 CML (2) SS Sanchez-Yus and Palou 31 1992 CML (1) SS Gonzalez-Castro et al 32 1991 CML (1) SS Mijovic et al 33 1991 CML (1) SS Elovaara et al 34 1990 CML (1) SS Bello Lopez et al 35 1990 CML (1) SS Cohen and Kurzrock 36 1989 CML (1) SS Hatch et al 37 1989 CML (1) SS Rauh et al 38 1989 CML (1) SS Visani et al 39 1988 CML (1) SS Marcos Sanchez et al 40 1985 CML (1) SS Odeh 41 1981 CML (1) SS Chmel and Armstrong 42 1978 CML (1) SS Rodriguez-Luaces et al 43 1997 CML (1) PAP Cordonnier et al 3 1994 CML (4) PAP Ito et al 44 1994 CML (1) PAP Miyake et al 45 1992 CML (1) PAP Watanabe et al 46 1990 CML (1) PAP Magy et al 47 1985 CML (1) PAP Aymard et al 48 1984 CML (1) PAP Green et al 49 1980 CML (1) PAP Miyashita et al 50 1977 CML (1) PAP Yamamoto et al 51 1975 CML (1) PAP Nakamura et al 52 1988 Graves (1) SS CML: chronic myeloid leukemia; PAP: pulmonary alveolar proteinosis; SS: Sweet syndrome.…”

Splenic irradiation-induced Sweet’s syndrome associated with preceding myelofibrosis

“…The pathogenesis of SS remains to be definitively determined. Based on a few reports of SS associated with radiotherapy, it seems that splenic irradiation can be one of the triggers 4,5 . Pertusi described a case of SS after splenic irradiation for chronic myelogenous leukaemia, in which treatment with corticosteroid resulted in a dramatic improvement 4 .…”