Previously established cancer is temporally associated with the appearance of the
Previously established cancer is temporally associated with the appearance of the dermatosis [15,49-60].Malignancy-associated Sweet’s syndrome is most often associated with acute myelogenous leukemia [61,62]. However, in patients with hematologic disorders, Sweet’s syndrome can occur in one or more of the following forms: a paraneoplastic syndrome, a drug-induced dermatosis, or a condition whose skin lesions concurrently demonstrate leukemia cutis. Carcinomas of the genitourinary organs, breast, and gastrointestinal tract are the most frequently occurring cancers in Sweet’s syndrome patients with dermatosis-related solid tumors [1,2,63-66].Drug-induced Sweet’s syndrome Several medications have been associated with the subsequent development of drug-induced Sweet’s syndrome (Table 3) [1,2,11,13,17,39,41,67124,398,401,404,417,426,435] (Figure 3). However, the drug-induced variant PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/26266977 of the dermatosis has most frequently been observed in patients following the administration of granulocyte-colony stimulating factor.Page 4 of(page number not for citation purposes)Orphanet Journal of Rare Diseases 2007, 2:http://www.OJRD.com/content/2/1/Recurrence of the dermatosis is often noted when the patient is rechallenged with the associated drug. However, once the causative agent has been discontinued, the disease manifestations frequently improve.arthralgia, general malaise, SF 1101 biological activity headache, and myalgia may also be present [1,2,23].Skin lesions Skin lesions of Sweet’s syndrome are typically tender. They appear as painful, red or purple-red, papules or nodules. Larger lesions may develop into plaques (Figures 1 and 2). The eruption is often distributed asymetrically. It presents as either a single lesion or multiple lesions. The most frequent lesion locations are the upper extremities, face, and neck (Figure 4) [1,10].Clinical descriptionSymptoms Sweet’s syndrome patients may appear dramatically ill. Fever is the most frequent symptom. Indeed, the skin eruption of Sweet’s syndrome is usually accompanied by fever and leukocytosis. However, the cutaneous manifestations of the disease may be preceded by several days to weeks of fever. Alternatively, pyrexia can be concurrently present throughout the entire episode of the dermatosis. Also, in some patients with biopsy-confirmed malignancy-associated Sweet’s syndrome, fever may be absent. Other Sweet’s syndrome-associated symptoms, such asThe Sweet’s syndrome lesions have a transparent, vesiclelike appearance because of the pronounced edema in the upper dermis; some lesions are morphologically similar to bullae [401,419]. Central clearing may lead to annular or arcuate patterns in latter stages. In patients with malig-Table 3: Medications associated with drug-induced Sweet’s syndrome [a-c]AntibioticsAntiepileptics Antihuman immunodeficiency virus drugs Antihypertensives AntineoplasticsAntipsychotics Antithyroid hormone synthesis drugs Colony stimulating factorsContraceptives [83] Diuretics Nonsteroidal anti-inflammatory agents RetinoidsMinocycline [110-112] Nitrofurantoin [113] Norfloxacin [114] Ofloxacin [115] Quinupristin/dalfopristin [118] Trimethoprim-sulfamethoxazole [11,13] Carbemazepine [17] Diazepam [86] Abacavir (synthetic carbocyclic nucleoside analogue) [69] Hydralazine [107] Bortezomib [d] [78-79] Imatinib mesylate [e] [108,109,401] Lenalidomide [f] [426] Clozapine [82] Propylthiouracil [117] Granulocyte-colony stimulating factor [39,41,89-105,398] Granulocyte-macrophage-colony stimulating factor [105,.
