Sweet syndrome with pseudocarcinomatous hyperplasia: A case report and review of the literature

Abstract

Pseudocarcinomatous (pseudoepitheliomatous) hyperplasia represents reactive epidermal change mimicking squamous cell carcinoma (SCC), owing to a variety of inflammatory and neoplastic phenomena, including deep fungal infections, CD30‐positive lymphomas, and others. We report a case of Sweet syndrome (SS) arising in a patient with acute myelogenous leukemia, with persistent orolabial involvement which mimicked SCC both clinically and microscopically, but resolved entirely with adequate corticosteroid treatment. Clinicians should be aware that neutrophilic dermatoses such as SS and pyoderma gangrenosum may rarely exhibit pseudocarcinomatous epidermal changes similar to those seen in soft tissue infections and other inflammatory dermatoses.

Pseudocarcinomatous Hyperplasia of the Nose and Necrotic Tracheitis Associated with Acute Myeloid Leukemia

“…Grunwald et al reported two types of PCH in the skin: an epithelial response with proliferation of basaloid cells and an epithelial response with proliferation of squamous cells toward cornification (4). In the present case, the histopathological findings of the nasal lesion suggested an epithelial response with proliferation of squamous cells toward cornifi- (2,12,13). Although Sweet syndrome is often seen in cases of hematologic malignancies, such as AML, PCH is a very rare dermal histopathological finding in AML (2,12).…”

“…Pseudocarcinomatous hyperplasia (PCH), also known as pseudoepitheliomatous hyperplasia, is a reactive epithelial proliferation that occurs in inflammatory conditions and malignant diseases such as CD30-positive lymphoproliferative disorders, acute myeloid leukemia (AML), non-tuberculous mycobacterial infection, and irradiation (1)(2)(3)(4)(5). PCH may be misdiagnosed as well-differentiated squamous cell carcinoma or keratoacanthoma (5,6).…”

Pseudocarcinomatous Sweet syndrome

“… 4 , 5 It is generally associated with infection (especially deep fungal infection), chronic inflammation, hypersensitivity reactions, and malignancy. 2 , 4 , 5 , 6 Histologically, PEH may closely resemble SCC, especially in biopsy specimens with insufficient dermis. 5 However, unlike SCC, the pathology of pSS lacks nuclear atypia, abundant or abnormal mitoses, and prominent dyskeratosis.…”

Unusual non-trophic ulcerations in leprosy: A case series of 17 patients

“…16 SS with pseudoepitheliomatous hyperplasia is rare and to the best of our knowledge, SS-like ENL with PEH and ulceration has not been described before, making it a peculiar feature in our patient both clinically and histologically, and also first of its kind. 19 The Lucio phenomenon as a cause for ulceration in leprosy is well established. 2 Characteristic histological features are epidermal and dermal necrosis with fibrinoid vasculitis and lepra bacilli in the vascular endothelium.…”