Concurrence of Sweet's Syndrome, Pathergy Phenomenon and Erythema Nodosum-like Lesions

Qiao, Jianjun; Wang, Yan; Bai, Juan; Wu, Yinhua; Fang, Hong

doi:10.1590/abd1806-4841.20153201

Cited by 12 publications

(5 citation statements)

References 11 publications

(28 reference statements)

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“…To our knowledge, this is the first reported case of SS demonstrating microscopic perifollicular involvement and clinical koebnerization associated with minor, grooming‐associated hair plucking. While koebernization and pathergy have previously been reported in association with SS, 3,4 the majority of reported cases are secondary to more significant cutaneous injury including surgical incisions, 7 burns, 12 venipuncture, peripheral cannulation, 13 cat scratches, radiation therapy, and pressure injury 4 …”

Section: Discussionmentioning

confidence: 99%

“…The Koebner phenomenon (also known as “ koebnerization”) is defined as development of an established cutaneous disease at sites of trauma, while pathergy is defined by hyper‐reactivity of the skin secondary to minor cutaneous trauma 2 . Both koebnerization and pathergy have been associated with SS, 3,4 with the majority of reported cases in response to direct cutaneous injuries, such as biopsies, surgical incisions, lacerations, and antigenic exposures 4 . Lesions arising within areas of minor trauma, including pressure, friction, adhesive application, adhesives and scarring, have also been reported 5‐10 …”

Section: Introductionmentioning

confidence: 99%

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Sweet syndrome with perifollicular involvement because of koebnerization from facial hair plucking

et al. 2021

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Sweet syndrome (SS), also known as acute febrile neutrophilic dermatosis, is an uncommon skin eruption characterized by fever, leukocytosis, and tender erythematous papules, nodules, and plaques. Histopathologically, SS lesions are characterized by marked superficial papillary edema with a dense neutrophilic infiltrate. SS is known to demonstrate both the Koebner phenomenon and pathergy. The majority of reported cases of these phenomena occur following significant cutaneous injury (e.g., biopsies, burns) rather than minor trauma such as pressure and friction. Here, we present the first known reported case of SS koebnerization secondary to minor grooming‐related hair plucking. In addition, this is also the first reported case to our knowledge of SS with perifollicular involvement on histopathology.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sweet syndrome with perifollicular involvement because of koebnerization from facial hair plucking

et al. 2021

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“…The most notable concept involves the pro-inflammatory potential of ultraviolet B in activating neutrophils and inducing the production of TNF-α and interleukin-8 ( 548 , 550 , 551 ). The formation of SS lesions in response to localized trauma has been demonstrated by lesions developing at sites of radiation therapy, surgery, burns, tattoos, and lymphedema ( 442 – 445 , 454 – 457 , 472 , 474 ).…”

Section: Pathogenesismentioning

confidence: 99%

Insights Into the Pathogenesis of Sweet's Syndrome

2019

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Sweet's syndrome, also known as Acute Febrile Neutrophilic Dermatosis, is a rare inflammatory condition. It is considered to be the prototype disease of neutrophilic dermatoses, and presents with acute onset dermal neutrophilic lesions, leukocytosis, and pyrexia. Several variants have been described both clinically and histopathologically. Classifications include classic Sweet's syndrome, malignancy associated, and drug induced. The cellular and molecular mechanisms involved in Sweet's syndrome have been difficult to elucidate due to the large variety of conditions leading to a common clinical presentation. The exact pathogenesis of Sweet's syndrome is unclear; however, new discoveries have shed light on the role of inflammatory signaling, disease induction, and relationship with malignancy. These findings include an improved understanding of inflammasome activation, malignant transformation into dermal infiltrating neutrophils, and genetic contributions. Continued investigations into effective treatments and targeted therapy will benefit patients and improve our molecular understanding of inflammatory diseases, including Sweet's syndrome.

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“…A unique finding in SS is pathergy. Cutaneous findings may appear after trauma including venipuncture or biopsy [61]. Histopathology shows neutrophilic infiltrates of the dermal papillae without evidence of leukoclastic vasculitis.…”

Section: Sweet's Syndrome (Acute Febrile Neutrophilic Dermatosis)mentioning

confidence: 99%

Skin Infections

Rihana¹,

Sampson²

2019

Infections in Neutropenic Cancer Patients

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Cutaneous infections are common in immunocompromised patients. Neutropenia predisposes patients to fungal, bacterial and viral infections. Antibacterial antifungal and antiviral prophylaxis have caused a significant reduction in some of these infections.There are two main types of cutaneous infections: primary cutaneous infections and cutaneous manifestations of a disseminated infection. In the latter, skin lesions may be the window to disseminated bloodstream infection and the first and only evidence of a disseminated life threatening infection.The diagnosis may be at your fingertips; therefore a thorough skin exam is the clue. However, it's also important to know the characteristic lesions associated with different infections. It will help expedite diagnosis so appropriate treatment is initiated promptly in neutropenic patients, which can be lifesaving.In a retrospective study of 43 neutropenic febrile patients with cutaneous lesions, fungal infections were the most frequent, and nodular lesions on the lower extremities were the most prevalent (Naorungroj and Aiempanakit, J Am Acad Dermatol 74:AB166, 2016).Skin biopsy for pathological study and culture remains the gold standard and should be obtained early to confirm the suspected diagnosis. In these immunocompromised patients the inflammatory response is altered by either the primary disease or its treatment. Therefore, routine pathogens may present in an atypical fashion, with diminished or absent induration, erythema, or pustulation in response to bacterial resulting cutaneous infection without typical cellulitis (Urabe, Clin Infect Dis 39:S53-S55, 2004). Skin lesions are evaluated not only by morphology, but also in the context of the clinical setting and biopsy result. The skin biopsy is inexpensive, relatively noninvasive and without contraindication, and may avoid the need for more invasive procedures such an open lung biopsy (Grossman, et al., Cutaneous manifestations of infection in the immunocompromised host. Springer Science+Business Media, LLC, New York, 2012).

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Concurrence of Sweet's Syndrome, Pathergy Phenomenon and Erythema Nodosum-like Lesions

Cited by 12 publications

References 11 publications

Sweet syndrome with perifollicular involvement because of koebnerization from facial hair plucking

Sweet syndrome with perifollicular involvement because of koebnerization from facial hair plucking

Insights Into the Pathogenesis of Sweet's Syndrome

Skin Infections

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