1
|
Peñuelas Leal R, Grau Echevarría A, Labrandero Hoyos C, Blaya Imbernon D, Lorca Sprohnle J, Finello M, Mayo Martinez F, Zaragoza Ninet V. Severe multi-refractory Sneddon-Wilkinson disease, with fast response to oral roflumilast treatment. J Eur Acad Dermatol Venereol 2024; 38:e467-e469. [PMID: 38059421 DOI: 10.1111/jdv.19653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/13/2023] [Indexed: 12/08/2023]
Affiliation(s)
| | | | | | | | | | - Malena Finello
- Consorci Hospital General Universitari de Valencia, Valencia, Spain
| | | | | |
Collapse
|
2
|
Wallach D. The Neutrophilic Dermatoses, or the Cutaneous Expressions of Neutrophilic Inflammation. Dermatol Clin 2024; 42:139-146. [PMID: 38423676 DOI: 10.1016/j.det.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Acute febrile neutrophilic dermatosis, or Sweet syndrome, has been described in 1964 and is now considered as a prototypical condition of the group of the neutrophilic dermatoses. Since this time, many clinical conditions have been included in this group and a clinical-pathological classification in 3 subgroups has been proposed. Neutrophilic infiltrates can localize in all internal organs. This defines the neutrophilic disease, which induces difficult diagnostic and therapeutic problems. Autoinflammation is the main pathophysiological mechanism of the neutrophilic dermatoses. There is a special link between myeloid malignancies (leukemia and myelodysplasia) and the neutrophilic dermatoses.
Collapse
|
3
|
Neutrophilic Dermatosis and Management Strategies for the Inpatient Dermatologist. CURRENT DERMATOLOGY REPORTS 2022; 11:146-157. [PMID: 35873076 PMCID: PMC9287689 DOI: 10.1007/s13671-022-00364-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2022] [Indexed: 11/29/2022]
Abstract
Purpose of Review Neutrophilic dermatoses are a heterogeneous group of disorders with significant overlap in associated conditions, clinical presentation, and histopathologic features. This review provides a structural overview of neutrophilic dermatoses that may present in the inpatient setting along with diagnostic work-up and management strategies. Recent Findings Sweet’s syndrome has been found in patients with coronavirus disease 2019 (COVID-19). Pyoderma gangrenosum (PG) has been shown to be equally associated with ulcerative colitis and Crohn’s disease. A clinical trial shows that cyclosporine is equally effective as prednisone in treating PG. Neutrophilic eccrine hidradenitis has been found in the setting of newer antineoplastic medications, such as BRAF inhibitors, as well as in the setting of malignancy without chemotherapy exposure. Summary Neutrophilic dermatoses are a rare and complex group of dermatoses with varying and overlapping clinical presentations. Physicians should be aware of the growing list of associated diseases in order to build a better differential diagnosis or to potentially investigate for co-existing disease.
Collapse
|
4
|
André F, Prins C, Gillet M, Guenova E, Blanchard G. CD30+ Transformed Mycosis Fungoides Associated with Sweet-like Dermatosis. Acta Derm Venereol 2022; 102:1170. [PMID: 35356992 PMCID: PMC9558759 DOI: 10.2340/actadv.v102.1170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2022] [Indexed: 11/27/2022] Open
Abstract
Abstract is missing (Short communication)
Collapse
Affiliation(s)
| | | | | | - Emmanuella Guenova
- Department of Dermatology, Lausanne University Hospital (CHUV) and Faculty of Biology and Medicine, University of Lausanne, Avenue de Beaumont 29, CH-1011 Lausanne, Switzerland.
| | | |
Collapse
|
5
|
Shibuya T, Nomura O, Nomura K, Haraikawa M, Haga K, Ishikawa D, Osada T, Yamaji K, Ikeda S, Nagahara A. Efficacy of cytapheresis for induction therapy and extra-intestinal skin manifestations of ulcerative colitis. Ther Apher Dial 2022; 26:522-528. [PMID: 35247233 DOI: 10.1111/1744-9987.13823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 12/14/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In recent years, the prevalence of inflammatory bowel diseases has been increasing in Japan due to the westernization of lifestyles. Many patients have been reported to have extra-intestinal manifestations (EIMs) at least once. Skin lesions occur with a high degree of frequency among EIMs, with erythema nodosum (EN) and pyoderma gangrenosum (PG) the main complications. Cytapheresis is again attracting attention as a treatment with few side effects. METHODS We investigated the therapeutic effect of cytapheresis on ulcerative colitis (UC) and cutaneous EIMs. Between 2008 and 2021, 240 patients with active UC had induction therapy by cytapheresis at our hospital. RESULTS Remission and response rates were 50.0% and 67.5%, respectively. Apheresis was performed on 7 patients with PG and 5 patients with EN with a good response. Serious adverse events were not observed. CONCLUSION This retrospective assessment of efficacy showed that EN and PG responded favorably to cytapheresis. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Tomoyoshi Shibuya
- Department of Gastroenterology, Juntendo University school of medicine
| | - Osamu Nomura
- Department of Gastroenterology, Juntendo University school of medicine
| | - Kei Nomura
- Department of Gastroenterology, Juntendo University school of medicine
| | - Mayuko Haraikawa
- Department of Gastroenterology, Juntendo University school of medicine
| | - Keiichi Haga
- Department of Gastroenterology, Juntendo University school of medicine
| | - Dai Ishikawa
- Department of Gastroenterology, Juntendo University school of medicine
| | - Taro Osada
- Department of Gastroenterology Juntendo University Urayasu Hospital
| | - Ken Yamaji
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine
| | - Shigaku Ikeda
- Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine
| | - Akihito Nagahara
- Department of Gastroenterology, Juntendo University school of medicine
| |
Collapse
|
6
|
Bhargava S, Kumar U, Kroumpouzos G. Subcorneal pustular dermatosis: Comprehensive review and report of a case presenting during pregnancy. Int J Womens Dermatol 2020; 6:131-136. [PMID: 32637535 PMCID: PMC7330443 DOI: 10.1016/j.ijwd.2020.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 01/21/2020] [Accepted: 02/06/2020] [Indexed: 01/06/2023] Open
Abstract
Subcorneal pustular dermatosis (SPD), also known as Sneddon-Wilkinson disease, is a rare, relapsing, sterile pustular eruption of unknown etiology that develops most commonly in middle-aged or mature women. This article reviews the presentation, associations, and management of the condition and highlights advances in pathophysiology. Onset of SPD during pregnancy has not been reported. Herein, we report a case of SPD that developed during pregnancy. The patient was treated with dapsone without complications for her or the fetus. An association between T helper (Th) 17 and Th2 environments in the development of SPD has been advocated. Pregnancy is characterized by a predominance of Th2 responses and increased interleukin-17 levels and thus may favor the development of the condition.
Collapse
Affiliation(s)
- Shashank Bhargava
- Department of Dermatology, R.D. Gardi Medical College, Ujjain, India
| | - Ujjwal Kumar
- Department of Dermatology, R.D. Gardi Medical College, Ujjain, India
| | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School, Brown University, Providence, Rhode Island, India
- GK Dermatology, PC, S Weymouth, Massachusetts, United States
- Department of Dermatology, Medical School of Jundiaí, São Paulo, Brazil
| |
Collapse
|
7
|
Pyoderma gangrenosum and erythema elevatum diutinum associated with a high-risk myelodysplastic syndrome: case report. Hematol Transfus Cell Ther 2018; 40:192-195. [PMID: 30057994 PMCID: PMC6001934 DOI: 10.1016/j.htct.2017.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 11/23/2017] [Indexed: 11/22/2022] Open
|
8
|
Moritz RK, Metze D, Wiebe S, Kerkhoff A, Berdel WE, Weishaupt C. Exacerbation of mycosis fungoides leading to the diagnosis of chronic myelomonocytic leukemia. JAAD Case Rep 2018; 4:270-273. [PMID: 29687069 PMCID: PMC5909678 DOI: 10.1016/j.jdcr.2017.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
9
|
Pyoderma gangrenosum avec anticorps anti-cytoplasme des neutrophiles de type anti-protéinase 3 (PR3-ANCA) induits par le propylthiouracile. Ann Dermatol Venereol 2017; 144:368-373. [DOI: 10.1016/j.annder.2017.01.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 07/12/2016] [Accepted: 01/13/2017] [Indexed: 12/16/2022]
|
10
|
Abstract
Subcorneal pustular dermatosis (SPD), also known as Sneddon-Wilkinson disease, is a rare, benign yet relapsing pustular dermatosis. Its incidence and prevalence have not been well studied. It characteristically presents as hypopyon pustules on the trunk and intertriginous areas of the body. SPD is similar to two other disease entities. Both SPD-type immunoglobulin (Ig)-A pemphigus and annular pustular psoriasis clinically and histologically present similarly to SPD. Immunologic studies separate SPD-type IgA pemphigus from SPD and pustular psoriasis. However, there is still an unclear designation as to whether SPD is its own entity distinct from pustular psoriasis, as the once thought characteristic histologic picture of psoriasis does not hold true for pustular psoriasis. SPD has been reported to occur in association with several neoplastic, immunologic, and inflammatory conditions. Dapsone remains the first-line treatment for SPD, although dapsone-resistant cases have been increasingly reported. Other therapies have been used singly or as adjunctive therapy with success, such as corticosteroids, immunosuppressive agents, tumor necrosis factor inhibitors, and ultraviolet light therapy. This article provides a review of the last 30 years of available literature, with a focus on successful treatment options and a suggestion for reappraisal of the classification of SPD.
Collapse
Affiliation(s)
- Paula Jean Watts
- Kansas City University of Medicine and Biosciences, 1750 Independence Avenue, Kansas City, MO, 64106, USA
| | - Amor Khachemoune
- Department of Dermatology, Veterans Affairs Medical Center Brooklyn and SUNY Downstate, 800 Poly Place, Brooklyn, NY, 11209, USA.
| |
Collapse
|
11
|
Morales-Moreno HJ, Montenegro-Damaso T, Peñate Y. Neutrophilic dermatosis associated with mycosis fungoides. JAAD Case Rep 2016; 1:333-6. [PMID: 27051771 PMCID: PMC4809374 DOI: 10.1016/j.jdcr.2015.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Hector Juan Morales-Moreno
- Department of Dermatology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Tarsila Montenegro-Damaso
- Department of Pathology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Yeray Peñate
- Department of Dermatology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| |
Collapse
|
12
|
Lozano-Masdemont B, Molina-López I, Parra-Blanco V, Suárez-Fernández R. Neutrophilic dermatosis of the hands (localized Sweet's syndrome). ACTA ACUST UNITED AC 2016; 13:53-54. [PMID: 26750182 DOI: 10.1016/j.reuma.2015.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 11/10/2015] [Accepted: 11/25/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Belén Lozano-Masdemont
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España.
| | - Irene Molina-López
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Verónica Parra-Blanco
- Anatomía Patológica, Hospital General Universitario Gregorio Marañón, Madrid, España
| | | |
Collapse
|
13
|
DeFilippis E, Feldman S, Huang W. The genetics of pyoderma gangrenosum and implications for treatment: a systematic review. Br J Dermatol 2015; 172:1487-1497. [DOI: 10.1111/bjd.13493] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2014] [Indexed: 12/22/2022]
Affiliation(s)
- E.M. DeFilippis
- Center for Dermatology Research; Department of Dermatology; Wake Forest School of Medicine, Medical Center Boulevard; Winston-Salem NC 27157 U.S.A
| | - S.R. Feldman
- Center for Dermatology Research; Department of Dermatology; Wake Forest School of Medicine, Medical Center Boulevard; Winston-Salem NC 27157 U.S.A
- Department of Pathology; Wake Forest School of Medicine, Medical Center Boulevard; Winston-Salem NC 27157 U.S.A
- Department of Public Health Sciences; Wake Forest School of Medicine, Medical Center Boulevard; Winston-Salem NC 27157 U.S.A
| | - W.W. Huang
- Center for Dermatology Research; Department of Dermatology; Wake Forest School of Medicine, Medical Center Boulevard; Winston-Salem NC 27157 U.S.A
| |
Collapse
|
14
|
Prat L, Bouaziz JD, Wallach D, Vignon-Pennamen MD, Bagot M. Neutrophilic dermatoses as systemic diseases. Clin Dermatol 2013; 32:376-88. [PMID: 24767185 DOI: 10.1016/j.clindermatol.2013.11.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Neutrophilic dermatoses (ND) are inflammatory skin conditions characterized by a sterile infiltrate of normal polymorphonuclear leukocytes. The main clinical forms of ND include Sweet syndrome, pyoderma gangrenosum, erythema elevatum diutinum, subcorneal pustular dermatosis, and their atypical or transitional forms. ND are often idiopathic, but they may be associated with myeloid hematologic malignancies (Sweet syndrome), inflammatory bowel disease or rheumatoid arthritis (pyoderma gangrenosum), and monoclonal gammopathies (erythema elevatum diutinum, subcorneal pustular dermatosis). The possible infiltration of internal organs with neutrophils during the setting of ND underlies the concept of a neutrophilic systemic disease. ND may be seen as a polygenic autoinflammatory syndrome due to their frequent association with other autoinflammatory disorders (monogenic or polygenic) and the recent published efficacy of interleukin-1 blocking therapies in their management.
Collapse
Affiliation(s)
- Lola Prat
- Université Paris Diderot, Sorbonne Paris Cité; AP-HP, Paris, France; Service de Dermatologie et Service d'Anatomo-Pathologie, Hôpital Saint Louis, 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - Jean-David Bouaziz
- Université Paris Diderot, Sorbonne Paris Cité; AP-HP, Paris, France; Service de Dermatologie et Service d'Anatomo-Pathologie, Hôpital Saint Louis, 1 Avenue Claude Vellefaux, 75010 Paris, France.
| | - Daniel Wallach
- Université Paris Diderot, Sorbonne Paris Cité; AP-HP, Paris, France; Service de Dermatologie et Service d'Anatomo-Pathologie, Hôpital Saint Louis, 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - Marie-Dominique Vignon-Pennamen
- Université Paris Diderot, Sorbonne Paris Cité; AP-HP, Paris, France; Service de Dermatologie et Service d'Anatomo-Pathologie, Hôpital Saint Louis, 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - Martine Bagot
- Université Paris Diderot, Sorbonne Paris Cité; AP-HP, Paris, France; Service de Dermatologie et Service d'Anatomo-Pathologie, Hôpital Saint Louis, 1 Avenue Claude Vellefaux, 75010 Paris, France
| |
Collapse
|
15
|
Dermatose neutrophilique aiguë pustuleuse au cours d’un mycosis fongoïde transformé agressif. Ann Dermatol Venereol 2013; 140:635-40. [DOI: 10.1016/j.annder.2013.04.088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 02/18/2013] [Accepted: 04/12/2013] [Indexed: 11/20/2022]
|
16
|
Granulomatous rosacea-like leukemid in a patient with acute myeloid leukemia. VOJNOSANIT PREGL 2008; 65:565-8. [PMID: 18700468 DOI: 10.2298/vsp0807565s] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Skin findings in leukemias may be divided into specific lesions (leukemia cutis) and non-specific lesions (leukemids) which may be found in up to 80% of all patients with leukemias. The leukemids vary clinically and they are usually a manifestation of bone marrow or immunologic impairment, but also Sweet syndrome, pyoderma gangrenosum, erythroderma, maculopapular exanthema, prurigo-like papules, generalized pigmentation, follicular mucinosis, generalized pruritus may be found during the course of leukemia. CASE REPORT We report a 70-year-old male with a 3-month history of erythema, papules and pustules on the face, ears and neck and over a month history of refractory anemia, anorexia, weight loss, malaise, and fever. Physical examination revealed symmetric erythematous, violaceous papules, papulo-nodules and plaques with slate scale and sparse, small pustules on the face, earlobes and neck. Histopathologic findings of involved skin showed diffuse mixed inflammatory cell infiltrate with perifollicular accentuation and focal granulomatous inflammation in the papillary and upper reticular dermis. Extensive checkup revealed the presence of acute myeloid leukemia French-American-British (FAB) classification subtype M2, with signs of three-lineage dysplasia. The patient was treated by L6 protocol which led to complete remission, both in bone marrow and skin, but after seven months he had relapse of leukemia with the fatal outcome. CONCLUSION This case indicates the importance of skin eruptions in the context of hematological malignancies.
Collapse
|
17
|
Piperacillin/Tazobactam-Induced Sweet Syndrome in a Patient With Chronic Lymphocytic Leukemia and Autoimmune Cholangitis. Am J Dermatopathol 2008; 30:203-4. [DOI: 10.1097/dad.0b013e318165db4a] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
18
|
Affiliation(s)
- Philip R Cohen
- Dermatologic Surgery Center of Houston, Department of Dermatology, University of Texas-Houston Medical School, Houston, TX, USA.
| |
Collapse
|
19
|
Trébol I, González-Pérez R, García-Rio I, Arregui MA, Saracibar N, Carnero L, Soloeta R. Paraneoplastic neutrophilic figurate erythema. Br J Dermatol 2007; 156:396-8. [PMID: 17223897 DOI: 10.1111/j.1365-2133.2006.07640.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
20
|
Sellier S, Levesque H, Courville P, Joly P. Dermatose neutrophilique, au décours d’une lymphadénopathie angio-immunoblastique, avec dysmyélopoïèse induite par le cyclophosphamide. Ann Dermatol Venereol 2006; 133:459-62. [PMID: 16760835 DOI: 10.1016/s0151-9638(06)70940-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cutaneous involvement in patients with angioimmunoblastic lymphadenopathy is often poorly specific for maculopapular eruptions. We report an atypical case of neutrophilic disorder associating subcorneal pustules and hypodermal nodules in a male patient with angioimmunoblastic lymphadenopathy. CASE REPORT A 62 year-old man with angioimmunoblastic lymphadenopathy was treated with oral prednisone (15 mg/day) and cyclophosphamide. Pustules and deep nodules occurred simultaneously on the arms and trunk, the abdomen and the back respectively. Biopsy of these lesions showed an infiltration of neutrophil polymorphonuclears in the median and superficial dermis with a subcorneal pustule and nodular infiltration of neutrophil polymorphonuclears in the deep dermis and hypodermis respectively. Increasing the dose of prednisone to 30 mg/day led to rapid and complete healing of the cutaneous lesions. DISCUSSION This atypical case of neutrophilic disorder associating acute subcorneal pustules and deep dermal-hypodermal nodules seems to correspond to a unique type of neutrophilic disorder that differs from those previously reported in the literature. Neutrophilic disorders have been reported only rarely in patients with angioimmunoblastic lymphadenopathy. This case illustrates the wide range of clinical and histological lesions found in neutrophilic disorders, a number of which may coexist in a single patient.
Collapse
Affiliation(s)
- S Sellier
- Clinique Dermatologique, CHU de Rouen, Rouen
| | | | | | | |
Collapse
|
21
|
Affiliation(s)
- Patrizia Zappasodi
- Division of Hematology and Department of Dermatology, University of Pavia, IRCCS Policlinico San Matteo, Italy.
| | | | | | | |
Collapse
|
22
|
Mellor PJ, Roulois AJA, Day MJ, Blacklaws BA, Knivett SJ, Herrtage ME. Neutrophilic dermatitis and immunemediated haematological disorders in a dog: suspected adverse reaction to carprofen. J Small Anim Pract 2005; 46:237-42. [PMID: 15909447 DOI: 10.1111/j.1748-5827.2005.tb00316.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This report describes the clinical and pathological findings of a suspected idiosyncratic adverse drug reaction in a young dog. The patient presented with sudden onset, severe skin lesions together with episodes of collapse. Investigations revealed a neutrophilic dermatitis with vasculitis, immune-mediated haemolytic anaemia and thrombocytopenia. Similar pathology has been described in human cases of Sweet's syndrome. The chronology of events suggested an adverse drug reaction to carprofen, although two antibiotics had been prescribed within the dog's recent history. Lymphocyte transformation tests were performed and tended to exclude both antibiotics as the cause of the reaction. To the authors' knowledge, lymphocyte transformation tests have not previously been described with regard to drug hypersensitivity assessment in the veterinary literature, and this is the first peer-reviewed case report of neutrophilic dermatitis and vasculitis with immune-mediated haemolytic anaemia and thrombocytopenia occurring as a suspected adverse drug reaction to carprofen in the dog.
Collapse
Affiliation(s)
- P J Mellor
- Queen's Veterinary School Hospital, University of Cambridge, Madingley Road, Cambridge CB3 0ES
| | | | | | | | | | | |
Collapse
|
23
|
Rafael MRMDSA, Fernandes CMBM, Machado JMDC, Rodrigues PAPA, Cardoso OJP, Afonso A, Sousa AB, Pacheco FMDDA, Proença RM. Pyoderma gangrenosum or leukaemia cutis? J Eur Acad Dermatol Venereol 2003; 17:449-51. [PMID: 12834459 DOI: 10.1046/j.1468-3083.2003.00766.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report a case of atypical bullous pyoderma gangrenosum associated with acute myeloid leukaemia in which we found atypical myeloid cells within the skin lesion. Although there have been many reported cases of leukaemia-associated pyoderma gangrenosum, the finding of myeloblasts in the skin has rarely been described.
Collapse
|
24
|
Vignon-Pennamen MD, Aractingi S. Sweet's syndrome and leukemia cutis: a common skin homing mechanism? Dermatology 2003; 206:81-4. [PMID: 12592072 DOI: 10.1159/000068462] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2002] [Accepted: 07/05/2002] [Indexed: 11/19/2022] Open
|
25
|
Yamauchi T, Ishida K, Iwashima Y, Ikegaya S, Kawai Y, Wakahara M, Kumakiri M, Ueda T. Successful treatment of pyoderma gangrenosum that developed in a patient with myelodysplastic syndrome. J Infect Chemother 2003; 9:268-71. [PMID: 14513399 DOI: 10.1007/s10156-003-0254-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2003] [Accepted: 05/20/2003] [Indexed: 11/25/2022]
Abstract
We describe the successful treatment of pyoderma gangrenosum (PG) that developed in a patient with myelodysplastic syndrome (MDS). A 63-year-old Japanese man with MDS was admitted to our hospital because of a large skin ulcer on his neck in November 2001. The initial diagnosis was infectious dermatitis, and antimicrobial therapy was performed, using imipenem/cilastatin, isepamicin, and amphotericin B. However, this therapy was not effective, and the lesion worsened. Cultures of blood, throat swab, and ulcer pus yielded no microorganisms. A biopsy of the skin lesion revealed a severe infiltration of neutrophils in the dermis, without any evidence of infection. The lesion was finally diagnosed as PG, and systemic administration of corticosteroid hormone was started in December 2001. The patient was initially pulsed with 1 g methylprednisolone daily for 3 days. The dose was immediately reduced, and the treatment was maintained with 30 mg prednisolone daily. The skin lesion responded markedly to the therapy, and C-reactive protein became negative. The patient was discharged in February 2002 because the lesion was almost cured. Prednisolone administration was tapered after 6-month maintenance therapy. No recurrence of PG was seen, although his MDS transformed into leukemia in April 2003. Only 31 cases of MDS developing PG have been reported in the past 20 years in Japan. This report describes one such rare patient who was successfully treated with the use of high-dose pulse methylprednisolone and long-term maintenance therapy.
Collapse
Affiliation(s)
- Takahiro Yamauchi
- First Department of Internal Medicine, Fukui Medical University, 23, Shimoaizuki, Matsuoka, Fukui 910-1193, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Abstract
A 20-year-old woman presented with a 4-month history of follicular papules distributed over the trunk and extremities. One month later, routine blood tests were abnormal, showing acute myeloblastic leukaemia (M1 in the French-American-British classification). Skin biopsy demonstrated a dermal infiltrate of a large number of neutrophils with occasional eosinophils and histiocytes in the vicinity of the hair follicle remnants. Intermingled in the infiltrate were atypical cells that were morphologically and immunohistochemically identical to leukaemic myeloblasts. Cultures of the papules and special stains of the biopsy specimen were negative for bacteria and fungi. The follicular eruption improved promptly in response to chemotherapy for the leukaemia. We suggest that this case may represent a rare, follicular variant of neutrophilic dermatosis associated with myelogenous leukaemia.
Collapse
Affiliation(s)
- M Inuzuka
- Department of Dermatology, Shizuoka General Hospital, 4-27-1 Kita-ando, Shizuoka 420-0881, Japan.
| | | |
Collapse
|
27
|
Park CJ, Bae YD, Choi JY, Heo PS, Lee KS, Park YS, Lee JA. Sweet's syndrome during the treatment of acute promyelocytic leukemia with all-trans retinoic acid. Korean J Intern Med 2001; 16:218-21. [PMID: 11769583 PMCID: PMC4531725 DOI: 10.3904/kjim.2001.16.3.218] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
All-trans retinoic acid (ATRA) is the standard induction treatment for acute promyelocytic leukemia (APL). Quite many ATRA-related side effects, including retinoic acid syndrome, were reported. So far, it has rarely been reported that Sweet's syndrome, characterized by fever, neutrophilia, painful erythematous cutaneous plaques, dense dermal infiltrates of mature neutrophils and rapid response to steroid therapy, is associated with ATRA. In the case that Sweet's syndrome associated with ATRA is found, physicians will have to face a great challenge over the possibility of infectious conditions. We present here a case of Sweet's syndrome associated with ATRA. A 35-year-old female with APL developed fever, painful erythematous cutaneous plaques on both cheeks, right wrist and both shins during induction chemotherapy with ATRA. A skin biopsy revealed a dense dermal infiltrate, consisting of mature neutrophils without vasculitis or cutaneous immunoglobulin deposits, which is compatible with Sweet's syndrome. Oral prednisone was administered and the lesions started to improve within 48 hours.
Collapse
Affiliation(s)
- C J Park
- Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, 445 Ghil-Dong, Kangdong-Ku, Seoul, 134-701, Korea
| | | | | | | | | | | | | |
Collapse
|
28
|
Nifosì G, Sbolli G, Ferrari B, Berte' R, Vallisa D, Civardi G, Cavanna L. Sweet's syndrome associated with monosomy 7 myelodysplastic syndrome. Eur J Intern Med 2001; 12:380-383. [PMID: 11395304 DOI: 10.1016/s0953-6205(01)00137-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Acute febrile neutrophilic dermatosis (Sweet's syndrome) is a reactive skin process frequently associated with inflammatory and neoplastic diseases, but particularly with hematologic malignancies. It usually precedes the underlying disorders for months or even years. Much of the evidence for this is based on a small series of case reports and reviews of the literature. Recently, immunological theories have suggested that helper T cell type 1 is involved in the pathogenesis of Sweet's syndrome. This process causes stimulation of the cytokine cascade, which may be responsible for the local and systemic activation of neutrophils and histiocytes. Clinically, Sweet's syndrome is characterized by an acute eruption of painful erythematous or violaceous plaques or nodules with fever, malaise, neutrophilic leukocytosis, and an elevated erythrocyte sedimentation rate. Peripheral blood neutrophilia is frequent and is one of the diagnostic criteria. However, 53% of patients with Sweet's syndrome linked to hematologic malignancies do not present any neutrophilia but rather granulocytopenia. Abnormal functioning of neutrophils is possible in many diseases. We report a case of a middle-aged male patient presenting Sweet's syndrome and granulocytopenia due to myelodysplasia and an anomalous chromosome seven (7-) with poor prognosis.
Collapse
Affiliation(s)
- G Nifosì
- Department of Internal Medicine - Hematology, Hospital of Piacenza, Piacenza, Italy
| | | | | | | | | | | | | |
Collapse
|