Acute febrile neutrophilic dermatosis
From IDWiki
Clinical Manifestations
- Sudden onset edematous, erythematous lesions (can be papules, nodules, or plaques)
- Fever, leukocytosis
Diagnostic Criteria
Classical Sweet Syndrome
- Requires both major criteria and at least 2 minor criteria
- Major criteria:
- Abrupt onset of painful erythematous plaques or nodules
- Histopathologic evidence of a dense neutrophilic infiltrate without evidence of leukocytoclastic vasculitis
- Minor criteria:
- Fever greater than 38 Celsius
- Underlying hematologic or solid-organ malignancy, inflammatory disease, or pregnancy; or preceded by an upper respiratory or GI infection or vaccination
- Excellent response to systemic corticosteroids or potassium iodide
- Abnormal bloodwork at presentation, with at least 3 of: ESR >20 mm/h, elevated CRP, WBC >8, neutrophils >70%
Drug-Induced Sweet Syndrome
- Requires the presence of all five criteria
- Criteria:
- Abrupt onset of painful erythematous plaques or nodules
- Histopathologic evidence of a dense neutrophilic infiltrate without evidence of leukocytoclastic vasculitis
- Fever greater than 38 Celsius
- Temporal relationship between drug ingestion and clinical presentation, or temporally-related recurrence after oral challenge
- Temporal relationship between drug withdrawal or treatment with systemic corticosteroids and resolution of lesions
