Neutrophilic pustulosis associated with chronic myeloid leukemia: a special form of Sweet's syndrome. Report of two cases

Acta Haematol. 1992;88(2-3):154-7. doi: 10.1159/000204674.

Abstract

Two subjects with Ph-positive chronic myeloid leukemia (CML) in whom pustular Sweet's syndrome was diagnosed are reported. The first patient was a 47-year-old woman who developed fever, painful ulcers of the oral mucosa and vagina and generalized pustulous skin lesions 2 years after the diagnosis of CML. Histologically, the skin lesions consisted of dense neutrophilic infiltrates with perifollicular disposition. The microbiologic studies were negative. The lesions showed a favorable response to corticosteroids, but fever recurred with every attempt of tapering prednisone; it finally disappeared with the addition of oral cyclophosphamide. The second patient was a 45-year-old man who developed fever and disseminated pustules with histologic features consistent with Sweet's syndrome and negative microbiologic studies at 2.5 years after diagnosis of CML. The picture showed a dramatic response to prednisone and did not recur after the drug was discontinued. In both patients, CML remained stable after resolution of Sweet's syndrome.

Publication types

  • Case Reports

MeSH terms

  • Cyclophosphamide / therapeutic use
  • Female
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / complications*
  • Male
  • Middle Aged
  • Neutrophils / pathology
  • Prednisone / therapeutic use
  • Sweet Syndrome / complications*
  • Sweet Syndrome / drug therapy
  • Sweet Syndrome / pathology

Substances

  • Cyclophosphamide
  • Prednisone