Probert C, Ehmann W C, al-Mondhiry H, Ballard J, Helm K F
Pennsylvania State University College of Medicine, USA.
Int J Dermatol. 1998 Feb;37(2):108-12. doi: 10.1046/j.1365-4362.1998.00270.x.
Sweet's syndrome (SS), acute febrile neutrophilic dermatosis, has been linked to hematologic malignancies and presents with characteristic edematous dermal plaques. Peripheral blood neutrophilia is frequently seen in association with SS and is one of the diagnostic criteria.
To report the clinical, laboratory, and hematologic data of four patients with myeloid leukemia who developed SS after chemotherapy. Three of these patients were neutropenic.
A retrospective study of four patients with SS and hematologic malignancies was undertaken. Three patients had de novo acute myelogenous leukemia and one was in the acute blast crisis of chronic myelogenous leukemia.
Sweet's syndrome was not originally suspected in these patients because of the low peripheral white blood cell counts caused by chemotherapy. All of the patients presented with fevers, arthralgias, and an eruption. They had been treated with antibiotics because of a presumed infection. Once the correct diagnosis was made and oral prednisolone was started, a rapid response followed.
Sweet's syndrome should be considered in the differential diagnosis when acute myeloid leukemic patients develop skin lesions and unexplained fevers regardless of the peripheral blood counts.
Sweet综合征（SS），即急性发热性嗜中性皮病，与血液系统恶性肿瘤有关，表现为特征性的水肿性皮肤斑块。外周血嗜中性粒细胞增多常见于SS患者，且是诊断标准之一。
报告4例化疗后发生Sweet综合征的髓系白血病患者的临床、实验室及血液学资料。其中3例患者为中性粒细胞减少。
对4例患有Sweet综合征和血液系统恶性肿瘤的患者进行回顾性研究。3例患者为初发急性髓系白血病，1例为慢性髓系白血病急性原始细胞危象。
由于化疗导致外周血白细胞计数低，这些患者最初未被怀疑患有Sweet综合征。所有患者均出现发热、关节痛和皮疹。因疑似感染，他们均接受了抗生素治疗。一旦做出正确诊断并开始口服泼尼松龙，病情迅速缓解。
当急性髓系白血病患者出现皮肤病变和不明原因发热时，无论外周血细胞计数如何，鉴别诊断中均应考虑Sweet综合征。
