Acute Febrile Neutrophilic Dermatosis (Sweet Syndrome)
This skin condition is marked by a fever and skin lesions that are usually reddish to blue or violet in color. The cause of Sweet Syndrome can vary, from certain types of cancer to an infection or medication. The lesions mostly occur in the upper extremity, neck and face region. In most cases, it will clear up after a few months after the underlying problem has been resolved.
Symptoms
- Red bumps that appear on the limbs, face, and neck
- Bumps grow quickly
- Lesions may be studded with pustules
- Subepidermal edema
- Moderate to high fever
- Possible conjunctivitis (pink eye)
- Fatigue
- Aching joints and headache
Diagnosis
Sweet Syndrome is rare, but you should see a doctor if you have recently had an upper respiratory tract infection or you have certain types of cancer, most commonly acute myeloid leukemia and tumors of the gastrointestinal tract. In order to diagnose this condition, your doctor will conduct a few tests.
- CBC to check for neutrophilia (elevated level of a type of white blood cells)
- A skin biopsy is performed to confirm diagnosis
- If CBC results are positive then a bone marrow biopsy is done to confirm
Causes
There are many known causes of Acute Febrile Neutrophilic Dermatitis, but some are more documented than others. For example, acute myeloid leukemia and some gastrointestinal cancers can be a cause of this condition. Infections are also liked with Sweet Syndrome, most commonly upper respiratory. Some medications such as lithium and oral contraceptives can lead to an outbreak as well.
Epidemology
Sweet syndrome is uncommon, only effecting a few hundred people each year. You cannot die from acute febrile neutrophilic dermatitis, but if it persists then you can experience prolonged pain and skin deterioration. This condition affects more women than men, at a ratio of 15:1. It does not affect one race more than another, and ages commonly range from 30-50. However, cases have been reported as early as 5 days of age.
Treatments
The primary treatment for sweet syndrome is prednisone, a corticosteroid. This drug affects parts of the immune system and is involved in inflammation. Other steroids can also help, such as topical ointments on localized areas and individual lesions. Combinations of drugs can also be effective, but none as much as corticosteroids. In order to get rid of the condition, the underlying problems have to be resolved. For example, infections should be treated and solid tumors removed. If this is done, the lesions should disappear and should never return.
Prognosis
Outlook could depend on the underlying condition. In 50% of cases, the lesions return. This is most common in patients with leukemia or suffer from sweet syndrome because of a drug reaction. Sweet syndrome cannot cause death, but can lead to discomfort and skin damage. Make sure to apply sunscreen before going outdoors and avoid trauma to the skin.