Giant Cellulitis-like Sweet Syndrome Following Varicose Vein Surgery: A Rare Variant of Sweet Syndrome Mimicking Cellulitis

Abstract

Giant cellulitis-like Sweet syndrome (GCS) is the most recently defined variant of Sweet syndrome (SS) which could clinically mimic wide-spreading cellulitis. Although there has been only paucity of reports in the literature, it mostly appears at lower half of the body and histologically shows dense infiltration of neutrophils with occasional histiocytoid mononuclear cells. Although its exact etiology has not been clarified, abnormal conditions (e.g., infection, malignancy and drugs) could be related triggering factors and trauma itself can be one of the causative elements as a ‘pathergy phenomenon’. GCS could be confusing manifestation especially when appeared in postoperative condition. A 69-year-old female presented with an erythematous edematous papules and plaques on the right thigh after varicose vein surgery. Skin biopsy revealed diffuse neutrophilic infiltrates that was consistent with SS. To our knowledge, there has been no report of GCS as a postoperative complication after varicose vein surgery. Physicians should be aware of this uncommon reactive neutrophilic dermatoses mimicking infectious cutaneous disease.

Sweet syndrome following routine orthopedic surgeries: A case series of 7 patients with surgical rechallenges

“…Patients with SS may present following an infection (most commonly upper portion of the respiratory tract and gastrointestinal tract) or with associated malignancy, inflammatory bowel disease, recent drug exposure, and/or pregnancy; however, idiopathic cases can also occur. 2 , 3 With regard to surgical procedures, SS has been described in the setting of varicose vein surgery, 4 spinal surgery, 5 pneumonectomy, 6 and coronary artery bypass grafting. 7 SS arising after orthopedic surgeries is rare; reported cases include development of SS 11 years after undergoing bilateral total knee arthroplasty, 8 3 weeks after a right tibial osteotomy, 9 and necrotizing SS 2 days after elective right partial palmar fasciectomy.…”