Giant Cellulitis-Like Sweet’s Syndrome

Links checked 4/04/17.

Sometimes, Sweet’s syndrome can occur in an unusual form. This is known as a disease variant.

What is cellulitis and cellulitis-like sweets syndrome?

Cellulitis is a bacterial infection of the skin that can cause Sweet’s syndrome or look like Sweet’s syndrome (Crum et el, 2003; Dinh et al, 2007; Morgan and Callen, 2001; Resende et al, 2016; Shugarman et al, 2011).

Sweet’s syndrome that looks like cellulitis is called cellulitis-like Sweet’s syndrome. It usually affects one part of the body, and is sometimes associated with cancer and blood disorders.

What is giant cellulitis-like Sweet’s syndrome?

Giant cellulitis-like Sweet’s syndrome is a rare variant of Sweet’s syndrome that affects a larger part of the body than cellulitis-like Sweet’s syndrome, and causes giant, raised-red lesions that often have a swollen appearance (Surovy et al, 2013a). It appears to be associated with obesity, sometimes cancer and blood disorders, and one case has been reported in a patient with the autoimmune condition Sjögren’s syndrome (Kaminska et al, 2014; Surovy et al, 2013b). In 2015, the first case of histiocytoid giant cellulitis-like Sweet’s syndrome was reported in a patient with myelodysplastic syndromes and myeloproliferative disorder (So et al, 2015).

How is it diagnosed?

A  swab of a skin lesion can be sent for culture to rule out cellulitis and infection as a cause (Cohen, 2007). Read more @ How is Sweet’s syndrome diagnosed?

How is it treated?

The main form of treatment is corticosteroid (steroid) therapy, but giant cellulitis-like Sweet’s syndrome has also been successfully treated with dapsone (Koketsu et al, 2014). Read more @ What is the treatment for Sweet’s syndrome?

References.

Cohen, P. (2007) Differential Diagnosis in Sweet’s syndrome – a comprehensive review of an acute febrile neutrophilic dermatosis (online).

Crum, N., Higginbottom, P., Fehl, F. and Graham, B. (2003) Sweet’s syndrome masquerading as facial cellulitis. Cutis, Jun;71(6):469-72 (PubMed).

Dinh, H., Murugasu, A. and Gin, D. (2007) Sweet’s syndrome associated with cellulitis. The Australasian Journal of Dermatology, May;48(2):105-9 (PubMed).

Kaminska, E., Nwaneshiudu, A., Luzuriaga, A., Tsoukas, M. and Bolotin, D. (2014) Giant cellulitis-like Sweet syndrome in the setting of autoimmune disease. Journal of the American Academy of Dermatology, Sept;71(3): e94–e95 (online).

Koketsu, H. Ricotti, C, and Kerdel, F. (2014) Treatment of giant cellulitis-like Sweet syndrome with dapsone. JAMA Dermatology, Apr;150(4):457-9 (online).

Morgan, K. and Callen, J. (2001) Sweet’s syndrome in acute myelogenous leukemia presenting as periorbital cellulitis with an infiltrate of leukemic cells. Journal of American Academy of Dermatology, Oct;45(4):590-5 (PubMed).

Resende, C., Santos, R., Pereira, T. and Brito, C. (2016) Sweet’s syndrome associated with cellulitis – a challenging diagnosis. Anais Brasileiros de Dermatologia, Jan-Feb; 91(1): 94–96 (online).

Shugarman, I., Schmit, J., Sbicca, J. and Wirk, B. (2011) Easily Missed Extracutaneous Manifestation of Malignancy-Associated Sweet’s Syndrome: Systemic Inflammatory Response Syndrome. American Society of Clinical Oncology, Aug 20; 29(24)(online).                                    

So, J., Carlos, C., Frucht, C. and Cohen, P. (2015) Histiocytoid giant cellulitis-like Sweet’s syndrome: case report and review of the literature. Dermatology Online Journal, Jan 25;21(3) (PubMed).

Surovy, A., Pelivani, N., Hegyi, I., Buettiker, U., Beltraminelli, H. and Borradori, L. (2013a) Figure 2, A., B., and C., in Giant Cellulitis-like Sweet Syndrome, a New Variant of Neutrophilic Dermatosis, JAMA Dermatology, Jan; 149(1):79-83 (online).

Surovy, A., Pelivani, N., Hegyi, I., Buettiker, U., Beltraminelli, H. and Borradori, L. (2013b) Giant Cellulitis-like Sweet Syndrome, a New Variant of Neutrophilic Dermatosis, JAMA Dermatology, Jan; 149(1):79-83 (online).

© 2012-2017 Sweet’s Syndrome UK

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