Department of Medical Oncology, Necmettin Erbakan University School of Medicine, Konya, Turkey.
J Oncol Pharm Pract. 2021 Jul;27(5):1307-1310. doi: 10.1177/1078155220963178. Epub 2020 Oct 7.
Sweet Syndrome, also known as acute febrile neutrophilic dermatosis, is a rare inflammatory disease characterized by the sudden emergence of painful, edematous, and erythematous papules, plaques, or nodules on the skin, which usually fully responsive to systemic corticosteroids. Skin lesions are often accompanied by fever and leukocytosis. Here we present a case of Sweet Syndrome caused by pemetrexed in metastatic lung adenocarcinoma.
A 52-year-old patient with metastatic lung adenocarcinoma received multiple lines of chemotherapy. The patient presented with extensive skin lesions after performing of pemetrexed chemotherapy. He had a fever and elevations in blood levels of C-reactive protein (CRP), sedimentation, leucocytes, and neutrophils. Neutrophil predominant perivascular and interstitial dermatitis, focal micropustule formation, and severe neutrophilic dermatosis were reported in skin biopsy. Topical steroid and oral antihistamine treatment were started as initial treatment. Cutaneous side effects related to pemetrexed are often reported as 'skin rash,' which is a non-specific term. Therefore, the diagnosis of Sweet Syndrome must be confirmed by skin biopsy. It is essential to exclude the presence of an infection and medication history. Recovery in drug-induced Sweet Syndrome occurs after the drug that caused it was discontinued. Systemic corticosteroids are the first-line treatment for most cases.
Sweet 综合征，又称急性发热性嗜中性皮病，是一种罕见的炎症性疾病，其特征为皮肤突然出现疼痛、肿胀和红斑性丘疹、斑块或结节，通常对全身皮质类固醇激素完全有反应。皮肤病变常伴有发热和白细胞增多。这里我们报告一例由培美曲塞引起的转移性肺腺癌中的 Sweet 综合征。
一名 52 岁的转移性肺腺癌患者接受了多线化疗。该患者在接受培美曲塞化疗后出现广泛的皮肤病变。他出现发热和 C 反应蛋白（CRP）、沉降率、白细胞和中性粒细胞水平升高。皮肤活检显示血管周围和间质中性粒细胞为主的皮炎、局灶性微脓疱形成和严重的中性粒细胞皮肤病。最初的治疗是开始局部皮质类固醇和口服抗组胺治疗。与培美曲塞相关的皮肤副作用通常被报告为“皮疹”，这是一个非特异性术语。因此，必须通过皮肤活检来确诊 Sweet 综合征。必须排除感染和药物史。停药后药物引起的 Sweet 综合征会恢复。大多数情况下，皮质类固醇激素是一线治疗。
