Department of Dermatology, Venerology and Allergology, University of Würzburg, Germany.
J Dtsch Dermatol Ges. 2011 Sep;9(9):666-9. doi: 10.1111/j.1610-0387.2011.07636.x. Epub 2011 Mar 29.
Sweet syndrome (acute febrile neutrophilic dermatosis) is characterized by a dramatic onset of high fever, neutrophilia and typical skin lesions. About 20 % of patients have an associated malignancy, most commonly hematologic diseases. Chronic and paucisymptomatic manifestations of Sweet syndrome may be misdiagnosed or misinterpreted as harmless, resulting in delayed diagnosis. "Atypical" manifestations are especially suspicious for associated malignancies. This is demonstrated by a 39-year old patient with chronic and afebrile disease who was referred to our clinic only after symptoms had persisted for several months. By that point, an underlying nodular lymphocyte predominant Hodgkin's lymphoma had already reached an advanced stage. Skin biopsies revealed dermal infiltrates of histiocytoid cells of myelogenous origin, supporting a diagnosis of histiocytoid Sweet syndrome. Specific cutaneous infiltrates associated with myelogenous leukemia were ruled out.
Sweet 综合征（急性发热性嗜中性皮病）的特征为突发高热、中性粒细胞增多和典型的皮肤损伤。约 20%的患者存在相关恶性肿瘤，最常见的是血液系统疾病。Sweet 综合征的慢性和症状较少的表现可能被误诊或错误解释为无害，导致诊断延迟。“非典型”表现尤其提示存在相关恶性肿瘤。这例 39 岁的慢性无热疾病患者就是如此，其症状持续数月后才被转诊至我科。此时，已经存在进展期结节性淋巴细胞为主型霍奇金淋巴瘤。皮肤活检显示源自髓系的组织细胞样真皮浸润，支持组织细胞样 Sweet 综合征的诊断。排除了与髓性白血病相关的特定皮肤浸润。
