A dermatologic emergency; Sweet's syndrome |
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| Institution: | 1. Cleveland Clinic Akron General, Department of Emergency Medicine, Akron, OH, United States of America;2. Northeast Ohio Medical University, Rootstown, OH, United States of America;3. Cleveland Clinic Akron General, Akron, OH, United States of America;4. Kent State University, Kent, OH, United States of America;5. Cleveland Clinic Emergency Services Institute, Cleveland, OH, United States of America;1. VA Tennessee Valley Healthcare System—Nashville, Department of Emergency Medicine, Nashville, TN, USA;2. Vanderbilt University, Department of Emergency Medicine, Nashville, TN, USA;3. Louis Stokes Cleveland VA Medical Center, Medicine Service, Cleveland, OH, USA;4. Case Western Reserve University School of Medicine, Department of Medicine, Cleveland, OH, USA;5. Orlando VA Medical Center, Department of Emergency Medicine, Orlando, FL, USA;6. University of Central Florida College of Medicine, Department of Medicine, Orlando, FL, USA;7. VA Pittsburgh Health Care Systems, Critical Care Service, Pittsburgh, PA, USA;8. University of Pittsburgh, Departments of Critical Care Medicine and Emergency Medicine, Pittsburgh, PA, USA;9. South Texas Veterans Health Care System, Medicine Service, San Antonio, TX, USA;10. UT Health San Antonio, Division of General & Hospital Medicine, San Antonio, TX, USA;11. White River Junction VA Medical Center, Medicine Service, White River, Junction, VT, USA;12. Dartmouth Geisel School of Medicine, Department of Medicine, Hanover, NH, USA;13. (m) UT Health San Antonio, Division of Pulmonary & Critical Care Medicine, San Antonio, TX, USA;14. Durham VA Health Care System, Primary Care Service, Durham, NC, USA;15. Duke University School of Medicine, Department of Medicine, Durham, NC, USA;p. VHA Specialty Care Service, VACO, Washington, DC, USA;1. UMass Memorial Medical Center, Department of Pharmacy, Worcester, MA, United States of America;2. UMass Memorial Medical School, Department of Emergency Medicine, Worcester, MA, United States of America;3. UMass Memorial Medical Center, Department of Emergency Medicine, Worcester, MA, United States of America;1. Department of Internal Medicine, Boston Medical Center, Boston, MA, USA;2. Section of Gastroenterology, Boston Medical Center, Boston, MA, USA;3. Boston University School of Public Health, Boston, MA, USA;1. Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA;2. St Mary''s Medical Center, West Palm Beach, FL, USA |
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| Abstract: | BackgroundSweet's syndrome (SS), also known as acute febrile neutrophilic dermatosis, is a rare condition characterized by recurrent erythematous skin lesions. Skin lesions appear as papules, nodules and plaques located on the upper extremity, trunk, neck and face.Case reportA 72-year-old male patient presented to the emergency department with a 10-day history of generalized rash, generalized muscle and joint pain and high fever. He had a history of upper respiratory tract infection. He presented with painful erythematous plaques on both lower and upper extremities and the trunk as well as serohemorrhagic bullous lesions on the feet. The laboratory results revealed WBC count of 20.6 × 103/mm3 (76.9% neutrophils), CRP (c-reactive protein) of 33 mg/L and erythrocyte sedimentation of 110/h. The patient was referred to a dermatologist with prediagnosis of SS due to the presence of typical painful skin lesions, high fever and neutrophilic leukocytosis. A systemic corticosteroid therapy was initiated. The diagnosis for SS was confirmed after the skin biopsy revealed the presence of dense dermal infiltrate of neutrophils and leukocytoclasis in the upper dermis. The patient responded rapidly to corticosteroids and the skin lesions improved.ConclusionWe reported this case as it was a rare life-threatening dermatosis diagnosed in the emergency department, which is generally difficult to diagnose therein, and the skin lesions appeared on the lower extremities. |
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