Smith Catherine Rachel, Williams Penelope
Department of Dermatology, Torbay and South Devon NHS Foundation Trust, Torquay, UK.
Department of Dermatology, Royal Devon and Exeter Hospital, Exeter, Devon, UK.
BMJ Case Rep. 2017 Aug 7;2017:bcr-2017-220317. doi: 10.1136/bcr-2017-220317.
Bullous Sweet's syndrome is a rare variant of the inflammatory neutrophilic dermatosis characterised by painful bullous skin lesions, fever, leukocytosis and a neutrophilic infiltrate of the dermis. The condition may be classified according to aetiology into classical (idiopathic), malignancy-associated and drug-induced. Neutrophilic infiltration occurs in response to a systemic insult. A punch biopsy for histology and culture is necessary due to its close resemblance to infection. Characteristic histology features a dense infiltration of neutrophils in the upper and mid dermis, oedema in the superficial dermis and endothelial swelling. Treatment with systemic glucocorticosteroids typically results in a dramatic clinical response. This case report illustrates a rare case of bullous Sweet syndrome associated with chronic lymphocytic leukaemia in a 53-year-old man.
大疱性斯威特综合征是一种罕见的炎症性嗜中性皮肤病变体，其特征为疼痛性大疱性皮肤损害、发热、白细胞增多以及真皮层嗜中性粒细胞浸润。该病症可根据病因分为经典型（特发性）、恶性肿瘤相关型和药物诱导型。嗜中性粒细胞浸润是对全身性损伤的反应。由于其与感染极为相似，因此需要进行组织学和培养的钻孔活检。特征性组织学表现为真皮上部和中部嗜中性粒细胞密集浸润、浅表真皮水肿和内皮肿胀。全身用糖皮质激素治疗通常会产生显著的临床反应。本病例报告展示了一名53岁男性中与慢性淋巴细胞白血病相关的罕见大疱性斯威特综合征病例。
