Sweet’s syndrome associated with chronic myelogenous leukemia: Demonstration of leukemic cells within a skin lesion

Sweet's syndrome – a comprehensive review of an acute febrile neutrophilic dermatosis

“…One theory is that the circulating immature myeloid precursor cells are innocent bystanders that have been recruited to the skin as the result of an inflammatory oncotactic phenomenon stimulated by the Sweet's syndrome lesions ("secondary" leukemia cutis) [165,206,207]. Alternatively, the leukemic cells within the skin may constitute the bonified incipient presence of a specific leukemic infiltrate ("primary" leukemia cutis) [207].…”

Bullous Sweet Syndrome in a Patient With t(9;22)(q34;q11)-Positive Chronic Myeloid Leukemia Treated With the Tyrosine Kinase Inhibitor Nilotinib

“…In our case, the cells also spread into the spongiotic epidermis, a sign frequently observed in SS associated with underlying malignant neoplasms. Recent case reports demonstrated leukemic cells within the skin infiltrate in patients with CML using fluorescence in situ hybridization 19 or polymerase chain reaction techniques 22 on lesional tissue. We were able to identify the BCR-ABL fusion indicating the Ph translocation t(9;22) (q34;q11) in a significant number of infiltrating cells, confirming these observations.…”

“…23 On the other hand, it has been supposed that the CML cells are only innocent bystanders attracted by the inflammatory process in the context of the SS. 22 Another hypothesis that may explain the coexistence of CML with SS deals with the fact that granulocyte-colony stimulating factor, which is capable of enhancing the neutrophilic maturation and mobilization, could induce a differentiation of the primary CML cells to mature neutrophils. 24 However, no granulocytecolony stimulating factor treatment was given to our patient.…”

Sweet’s Syndrome and Leukemia cutis: A Common Skin Homing Mechanism?

“…A definitive diagnosis for such mixed infiltrates was difficult, thus opening the possibility to a new classification of the old separated categories. More interestingly, the presence at the site of Sweet’s syndrome lesions of DNA with the same chromosomal abnormality as the one found in the underlying malignant hemopathy has been reported in AML and in chronic myelogenous leukemia by PCR targetting bcr/abl [25, 26, 27], demonstrating that malignant cells may be found within the infiltrate of ND. One karyotypic abnormality of chromosome 3q, which includes genes affecting the regulation of granulopoiesis and neutrophil migration [25], has been reported in Sweet’s syndrome.…”