Kaszewski Sebastian, Czajkowski Rafał, Protas-Drozd Franciszka, Placek Waldemar, Jakubowski Sebastian
Department of Dermatology, Sexually Transmitted Diseases and Immunodermatology, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland. Head of Department: Rafał Czajkowski MD, PhD.
Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, University of Warmia and Mazury, Olsztyn, Poland. Head of Department: Prof. Waldemar Placek MD, PhD.
Postepy Dermatol Alergol. 2014 Feb;31(1):47-52. doi: 10.5114/pdia.2014.40661. Epub 2014 Feb 25.
Diagnosis of paraneoplastic skin syndromes associating neoplastic processes is assumed as the crucial aspect of dermatological practice. Knowledge of clinical findings of dermatoses suggesting coincidence of malignant proliferative processes facilitates diagnostic and therapeutic procedures. We would like to present a case of Sweet's syndrome, qualified for comparative paraneoplastic skin syndromes. Sweet's syndrome, acute, febrile neutrophilic dermatosis, was first described by Robert Douglas Sweet in 1964 as a disorder characterized by fever, skin lesions of erythematous-infiltrative character, leukocytosis with neutrophilia and dense infiltrations of dermis by mature neutrophils. Sweet's syndrome aetiology is not fully understood, although cytokine abnormalities suggest that Th1 lymphocytes play an important role in pathogenesis of the dermatosis. Factors inducing Sweet's syndrome include: haematopoietic hyperplasia; neoplasms: genitourinary, breast, gastrointestinal; infections of the respiratory and alimentary system; inflammatory bowel diseases; drugs; pregnancy and vaccinations. Systemic corticosteroids are the "gold standard" of Sweet's syndrome treatment; potassium iodide or colchicine may also be used. Indomethacin, clofazimine, cyclosporine A and sulfones are the second-line drugs.
肿瘤相关性皮肤综合征与肿瘤性病变的诊断被认为是皮肤科临床实践的关键环节。了解提示恶性增殖性病变并存的皮肤病临床症状，有助于诊断和治疗过程。我们想介绍一例符合比较性肿瘤相关性皮肤综合征的Sweet综合征病例。Sweet综合征，即急性发热性嗜中性皮病，于1964年由罗伯特·道格拉斯·斯威特首次描述，是一种以发热、红斑浸润性皮肤损害、伴有嗜中性粒细胞增多的白细胞增多症以及真皮层有成熟嗜中性粒细胞密集浸润为特征的疾病。尽管细胞因子异常表明Th1淋巴细胞在该皮肤病的发病机制中起重要作用，但Sweet综合征的病因尚未完全明确。诱发Sweet综合征的因素包括：造血增生；肿瘤：泌尿生殖系统、乳腺、胃肠道肿瘤；呼吸道和消化系统感染；炎症性肠病；药物；妊娠和疫苗接种。系统性糖皮质激素是Sweet综合征治疗的“金标准”；碘化钾或秋水仙碱也可使用。吲哚美辛、氯法齐明、环孢素A和砜类药物为二线用药。
