Acute febrile neutrophilic

dermatosis
(Sweet’s syndrome)
Deba P Sarma, MD
Omaha
F 40, tender plaques, both legs, sudden
onset with fever and leukocytosis
Intact epidermis, papillary dermal edema, intense dermal neutrophilic
infiltration
Acute neutrophilic dermatitis, abundant nuclear
dust, no fibrinoid necrosis of vessels
Acute neutrophilic dermatitis, abundant nuclear dust,
no fibrinoid necrosis of vessels
 Comment

 Intact epidermis, papillary dermal edema, diffuse

neutrophilic infiltrates of upper and deep dermis.

 Nuclear dusts, but no fibrinoid necrosis or

vasculitis.
 Comment
 Sweet's syndrome (acute febrile neutrophilic dermatosis) is
characterized by fever, leukocytosis, and tender, erythematous,
well-demarcated papules and plaques which show dense
neutrophilic infiltrates on histologic examination.

 Epidermis is normal, dense neutrophilic infiltration in dermis,

no fibrinoid necrosis of vessels or leukocytoclastic vasculitis.

 Although it may occur in the absence of other known disease,

Sweet's syndrome is often associated with hematologic
disease (including leukemia), and immunologic disease
(rheumatoid arthritis, inflammatory bowel disease).
 Sweet’s syndrome, clinical associations

 Idiopathic/Classic (70%): F>M, 50’s.

 Associated with hematopoietic malignancy (leukemia) or other

solid malignant tumors.

 Associated with immunologic diseases (relapsing

polychondritis, rheumatoid arthritis, dermatomyositis,
inflammatory bowel disease).