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Sweet's Syndrome Limited on the Palms and Soles: A Case Report

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초록

Sweet's syndrome was first described as a reactive dermatosis characterized by sudden onset of fever, leukocytosis, and erythematous plaques infiltrated with neutrophils. Therefore, Sweet's syndrome is also known as acute febrile neutrophilic dermatosis. However, subsequently, it became clear that fever and neutrophilia in Sweet's syndrome vary depending on the case, and several other characteristics have been described. The lesions in Sweet's syndrome are typically observed not only in the limbs but also in the face, neck, and upper trunk. A 28-year-old female without a specific medical history presented in a hospital following the complaint of painful erythematous patches and pustules on her palms and soles. She had no previous history of palmoplantar pustulosis and other infections or malignancies. A skin biopsy showed diffuse dermal infiltration of neutrophils. Laboratory tests showed increased neutrophil count and erythrocyte sedimentation rate. After systemic corticosteroid administration was initiated, the lesions gradually disappeared. The patient was subsequently diagnosed with Sweet's syndrome according to histology, clinical feature, and response to treatment. However, there have been few reports of Sweet's syndrome confined to the individuals' palms and soles. According to the literatures, although the dorsum of the hand is frequently affected, the palmoplantar involvement as in our case appears to be rare.

Abstract

Sweet's syndrome was first described as a reactive dermatosis characterized by sudden onset of fever, leukocytosis, and erythematous plaques infiltrated with neutrophils. Therefore, Sweet's syndrome is also known as acute febrile neutrophilic dermatosis. However, subsequently, it became clear that fever and neutrophilia in Sweet's syndrome vary depending on the case, and several other characteristics have been described. The lesions in Sweet's syndrome are typically observed not only in the limbs but also in the face, neck, and upper trunk. A 28-year-old female without a specific medical history presented in a hospital following the complaint of painful erythematous patches and pustules on her palms and soles. She had no previous history of palmoplantar pustulosis and other infections or malignancies. A skin biopsy showed diffuse dermal infiltration of neutrophils. Laboratory tests showed increased neutrophil count and erythrocyte sedimentation rate. After systemic corticosteroid administration was initiated, the lesions gradually disappeared. The patient was subsequently diagnosed with Sweet's syndrome according to histology, clinical feature, and response to treatment. However, there have been few reports of Sweet's syndrome confined to the individuals' palms and soles. According to the literatures, although the dorsum of the hand is frequently affected, the palmoplantar involvement as in our case appears to be rare.

참고문헌 (13)

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  2. Cohen PR, "Sweet’s syndrome : a neutrophilic dermatosis classically associated with acute onset and fever", Clin Dermatol, 18, pp.265~282 (2000)
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  6. Neoh CY, "Sweet’s syndrome : a spectrum of unusual clinical presentations and associations", Br J Dermatol, 156, pp.480~485 (2007)
  7. Su WP, "Diagnostic criteria for Sweet’s syndrome", Cutis, 37, pp.167~174 (1986)
  8. Giasuddin AS, "Sweet’s syndrome : is the pathogenesis mediated by helper T cell type 1 cytokines", J Am Acad Dermatol, 39, pp.940~943 (1998)
  9. Kawakami T, "Elevated serum granulocyte colony-stimulating factor levels in patients with active phase of sweet syndrome and patients with active behcet disease : implication in neutrophil apoptosis dysfunction", Arch Dermatol, 140, pp.570~574 (2004)
  10. von den Driesch P, "Sweet’s syndrome(acute febrile neutrophilic dermatosis)", J Am Acad Dermatol, 31, pp.535~556 (1994)[DOI]
  11. Sitjas D, "Acute febrile neutrophilic dermatosis(Sweet’s syndrome)", Int J Dermatol, 32, pp.261~268 (1993)
  12. Keefe M, "Sweet’s syndrome, plantar pustulosis and vulval pustules", Clin Exp Dermatol, 13, pp.344~346 (1988)
  13. Sommer S, "Sweet’s syndrome presenting as palmoplantar pustulosis", J Am Acad Dermatol, 42(2 Pt 2), pp.332~334 (2000)

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