Extracutaneous neutrophilic inflammation in a dog with lesions resembling Sweet's Syndrome

Abstract

A 7-year-old-spayed female standard poodle dog presented to the Iowa State University Veterinary Teaching Hospital with an 8-day history of lethargy, left hind limb lameness, ptyalism and peripheral lymphadenomegaly. On physical examination, the dog was lethargic, febrile (40.5 degrees C) and had multifocal to coalescing erythematous papular to pustular eruptions on the skin of all four limbs, periocularly and on the ventral and lateral thorax and abdomen. Histopathological findings from skin biopsies of the papules revealed a severe diffuse neutrophilic dermatitis with sub- and intra-epithelial pustules. Four days after being admitted the dog died from cardiac and respiratory failure. At necropsy, in addition to the multifocal to coalescing erythematous papules, the skin contained scattered pustules. Additionally, the subcutaneous tissue surrounding the right stifle was diffusely oedematous, and the peripheral and visceral lymph nodes were enlarged. The predominant histologic lesion was neutrophilic inflammation, in the absence of detectable bacteria in the skin, heart, lungs, oesophagus and left tarsus. In the absence of neoplasia or bacteraemia, a syndrome similar to Sweet's Syndrome should be considered as a differential diagnosis in dogs with cutaneous and extracutaneous neutrophilic infiltrates.

Exophthalmos due to sterile neutrophilic dermatosis in a dog

“…In the following report, we describe a case of exophthalmos and periorbital inflammation in a dog diagnosed with sterile neutrophilic dermatosis. The condition is uncommonly reported in the veterinary literature, and to the authors’ knowledge, this is the first veterinary case report describing periorbital involvement …”

“…Other reported extracutaneous signs include polyarthritis, anemia, and thrombocytopenia . A case report from Johnson et al . described a dog with neutrophilic dermal infiltration of the cutaneous lesions, as well as neutrophilic inflammation of the heart, lungs, esophagus, and synovium.…”

“…4 Other reported extracutaneous signs include polyarthritis, 6 anemia, and thrombocytopenia. 8 A case report from Johnson et al 5 described a dog with neutrophilic dermal infiltration of the cutaneous lesions, as well as neutrophilic inflammation of the heart, lungs, esophagus, and synovium. As with Sweet's syndrome in humans, the histopathologic characteristics of sterile neutrophilic dermatosis in dogs are moderate-to-severe neutrophilic inflammatory infiltrate of the dermis in the absence of identifiable infectious agents.…”

“…The condition is uncommonly reported in the veterinary literature, and to the authors' knowledge, this is the first veterinary case report describing periorbital involvement. [3][4][5][6][7][8]…”

Discriminatory features of acute eosinophilic dermatitis with oedema (Wells‐like syndrome) and sterile neutrophilic dermatosis (Sweet's‐like syndrome) in dogs

“…Some authors have likened CAEDE to the human entity of Wells’ syndrome, an eosinophilic and granulomatous cellulitis first reported in 1971, although the histological lesions differ between the canine and human conditions . Sterile neutrophilic dermatosis is a rare disease in dogs, reported in few case studies, that has been compared to acute febrile neutrophilic dermatosis (Sweet's syndrome) of humans …”