Abbas Syeda Wajiha, Shah Zarnain, Shaikh Mohammad Usman
Internal Medicine, Aga Khan University, Karachi, Pakistan.
Internal Medicine, Aga Khan University, Karachi, Pakistan
BMJ Case Rep. 2022 Dec 1;15(12):e250755. doi: 10.1136/bcr-2022-250755.
A woman in her 40s presented with a 3-month-long history of fever and tender erythematous bullous skin lesions not responsive to antibiotics. There had been no previous gastrointestinal, respiratory or urinary infection, nor did she have any history of autoimmune disease, drug reaction or vasculitis.Histological evaluation of skin biopsy showed diffuse dense neutrophilic infiltrates located in dermis diagnostic of Sweet syndrome. Haematological investigations showed leucocytosis with circulating immature cells, which on further investigations with bone marrow biopsy, were evident of chronic myelogenous leukaemia in the accelerated phase. Sweet syndrome was the presenting characteristic of chronic myelogenous leukaemia in this case, which is a rare association. Investigating unusual skin lesions can aid in the suspicion of underlying cancer, allowing for prompt action.
一名40多岁的女性出现了长达3个月的发热和压痛性红斑性大疱性皮肤病变，对抗生素治疗无反应。既往无胃肠道、呼吸道或泌尿系统感染史，也无自身免疫性疾病、药物反应或血管炎病史。皮肤活检的组织学评估显示，真皮中有弥漫性致密中性粒细胞浸润，诊断为Sweet综合征。血液学检查显示白细胞增多，伴有循环未成熟细胞，进一步进行骨髓活检发现，这是慢性粒细胞白血病加速期的表现。在本例中，Sweet综合征是慢性粒细胞白血病的首发特征，这种关联较为罕见。对不寻常的皮肤病变进行检查有助于怀疑潜在的癌症，从而能够及时采取行动。
