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

• Published in: Journal of the American Academy of Dermatology 2007-04, Vol.56 (4), p.690-693
• Main Authors: Jagdeo, Jared, BA, Campbell, Ross, MD, Long, Thomas, MD, Muglia, Jennie, MD, Telang, Gladys, MD, Robinson-Bostom, Leslie, MD
• Format: Article
• Language: English
• Subjects: Adult; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Biological and medical sciences; Biopsy, Needle; Dermatology; Follow-Up Studies; Hematologic and hematopoietic diseases; Humans; Immunohistochemistry; Leukemia, Promyelocytic, Acute - drug therapy; Leukemia, Promyelocytic, Acute - pathology; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Neutrophils; Panniculitis - chemically induced; Panniculitis - drug therapy; Panniculitis - pathology; Risk Assessment; Skin involvement in other diseases. Miscellaneous. General aspects; Sweet Syndrome - chemically induced; Sweet Syndrome - drug therapy; Sweet Syndrome - pathology; Treatment Outcome; Tretinoin - adverse effects; Tretinoin - therapeutic use
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2006.08.011

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.