Sweet's syndrome--like neutrophilic lobular panniculitis associated with all-trans-retinoic acid chemotherapy in a patient with acute promyelocytic leukemia

J Am Acad Dermatol. 2007 Apr;56(4):690-3. doi: 10.1016/j.jaad.2006.08.011.

Abstract

Sweet's syndrome-like (Sweet's-like) neutrophilic panniculitis is usually idiopathic, but is frequently associated with hematologic, inflammatory, and immunologic disease. Drug-related cases of Sweet's syndrome have been reported. Of relevance, chemotherapy with the retinoid all-trans-retinoic acid (ATRA) infrequently induces Sweet's-like neutrophilic panniculitis that occurs concomitantly with neutrophilic differentiation. The pathologic features are limited to the adipose tissue or include both the dermis and the subcutaneous fat; the neutrophilic infiltrate can be observed in the lobules, the septae, or both. We present this case because of the unusual subcutaneous neutrophilic infiltrate consistent with Sweet's-like neutrophilic lobular panniculitis in a patient with acute promyelocytic leukemia receiving ATRA chemotherapy. This case highlights the important connection between ATRA and Sweet's syndrome.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Biopsy, Needle
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Leukemia, Promyelocytic, Acute / drug therapy*
  • Leukemia, Promyelocytic, Acute / pathology
  • Male
  • Neutrophils
  • Panniculitis / chemically induced*
  • Panniculitis / drug therapy
  • Panniculitis / pathology
  • Risk Assessment
  • Sweet Syndrome / chemically induced*
  • Sweet Syndrome / drug therapy
  • Sweet Syndrome / pathology
  • Treatment Outcome
  • Tretinoin / adverse effects*
  • Tretinoin / therapeutic use

Substances

  • Antineoplastic Agents
  • Tretinoin