Acute febrile neutrophilic dermatosis

(Sweet’s syndrome)

Deba P Sarma, MD
Omaha
F 40, tender plaques, both legs, sudden

onset onset with fever and leukocytosis

Intact epidermis, papillary dermal edema, intense
dermal neutrophilic infiltration
Acute neutrophilic dermatitis, abundant nuclear
dust, no fibrinoid necrosis of vessels
Acute neutrophilic dermatitis, abundant nuclear dust,
no fibrinoid necrosis of vessels
Comment

 Intact epidermis, papillary dermal edema, diffuse

neutrophilic infiltrates of upper and deep dermis.

 Nuclear dusts, but no fibrinoid necrosis or vasculitis.

 Sweet's syndrome (acute febrile neutrophilic dermatosis) is
characterized by fever, leukocytosis, and tender,
erythematous, well-demarcated papules and plaques which
show dense neutrophilic infiltrates on histologic
examination.

 Epidermis is normal, dense neutrophilic infiltration in

dermis, no fibrinoid necrosis of vessels or leukocytoclastic
vasculitis.

 Although it may occur in the absence of other known

disease, Sweet's syndrome is often associated with
hematologic disease (including leukemia), and immunologic
disease (rheumatoid arthritis, inflammatory bowel disease).
 Sweet’s syndrome, clinical associations

 Idiopathic/Classic (70%): F>M, 50’s.

 Associated with hematopoietic malignancy (leukemia) or

other solid malignant tumors.

 Associated with immunologic diseases (relapsing

polychondritis, rheumatoid arthritis, dermatomyositis,
inflammatory bowel disease).