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Anaemia, leukopaenia, thrombocytopaenia tied to malignancy in Sweet syndrome

24 Jan 2018

Dermatologists who manage patients with Sweet syndrome, a rare skin disorder, should be conscious of the potential association of leukopaenia, anaemia, thrombocytopaenia, absence of arthralgia, and histiocytoid or subcutaneous histopathology with malignancy, suggests a recent study.

In total, 83 patients (mean age 57 years; 51 percent male) were diagnosed with Sweet syndrome (30 percent with the classic form, 44 percent with the malignancy-associated form, 24 percent with the drug-induced form in the setting of malignancy, and 2 percent with the drug-induced form).

The most common malignancy was acute myeloid leukaemia (in 24 of 83 patients; 29 percent), and the most common medication used was filgrastim (in eight of 83 patients; 10 percent). Malignancy (χ2 test) was associated with leukopaenia (p<0.001), anaemia (p=0.002), thrombocytopaenia (p<0.001), absence of arthralgia (p<0.001), and histiocytoid or subcutaneous histopathology (p=0.024).

“This was a retrospective study that represents patients from a single tertiary academic referral centre, which may limit its generalizability to other settings,” researchers said.

Patients with Sweet syndrome at the University of Pennsylvania were retrospectively reviewed from 2005 to 2015 in order to describe the clinicopathologic characteristics and treatment of the rare disorder and identify characteristics related to concurrent malignancy.

“Sweet syndrome is a neutrophilic dermatosis that may be categorized into classic, malignancy-associated and drug-induced subtypes,” explained researchers.

In one study, Sweet syndrome was described as a distinctive disease with certain clinical and histologic characteristics, which usually has a complete response to systemic corticosteroids. The investigators stressed the importance of assessing patients with Sweet syndrome who have laboratory evidence of anaemia for an underlying malignancy. [J Am Acad Dermatol 2013;69557-564]

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