Neutrophilic eccrine hidradenitis masquerading as facial cellulitis

Neutrophilic eccrine hidradenitis typically manifests as erythematous plaques on the face, trunk, or extremities. This eruption has been associated with numerous factors, but most commonly is seen with chemotherapy, particularly cytarabine. We report a 73-year-old woman with acute myelogenous leukemia who developed rapidly expansive neutrophilic eccrine hidradenitis mimicking facial cellulitis only after a course of cytarabine was followed by granulocyte-colony stimulating factor. Prompt diagnosis is imperative to prevent prolonged antimicrobial therapy.     

Sweet's syndrome associated with cellulitis

A 38-year-old woman developed an acute, painful cutaneous eruption on her lower legs, neck, chest and fingers while receiving a number of oral and intravenous antibiotics for left leg cellulitis caused by trauma. Clinically and histopathologically, she was diagnosed with Sweet's syndrome with typical pseudovesicular skin changes in conjunction with erythema nodosum-like lesions on her lower legs. She responded quickly to oral prednisolone. We propose Staphylococcal cellulitis as a cause of Sweet's syndrome.     

Subcutaneous sarcoidosis masquerading as cellulitis

Sarcoidosis is a multisystem disease encountered by general physicians as well as medical specialists. Subcutaneous sarcoidosis is not an uncommon clinical presentation of sarcoidosis and is challenging for physicians because it can mimic cellulitis or several chronic infections. Our patient presented with a swollen forearm and hand which were initially treated as acute cellulitis with antibiotics by general physicians but without any improvement. A skin biopsy showed granulomatous panniculitis but confirmation of the diagnosis of systemic sarcoidosis was based on the characteristic chest roentgenogram, the high CD4/CD8 ratio of T lymphocytes in bronchoalveolar lavage, and the typical 'panda' and 'lambda' signs on the (67)Ga scan. Such cases with atypical clinical presentation cause some difficulty in reaching the diagnosis but a skin biopsy as well as typical imaging and laboratory signs are usually important to establish the diagnosis of sarcoidosis, when invasive procedures cannot be performed to get confirmation from a second target organ.     

Sweet's syndrome associated with cellulitis - a challenging diagnosis

Sweet''s syndrome is a neutrophilic dermatosis with worldwide distribution thathas been associated with inflammatory autoimmune diseases, infections,malignancies, drugs, and pregnancy. The disease is idiopathic in up to 50% ofpatients. A 64-year-old woman, diagnosed with right limb cellulitis (4 days ofevolution), was seen at our department, due to persistent cellulitis andprogressive appearance of painful nodules and plaques in both shins and theright forearm (2 days of evolution). Taken together, clinical, laboratory andpathological data suggested the diagnosis of Sweet''s syndrome, probablysecondary to cellulitis of the right inferior limb. We suggest that cellulitismay be associated with Sweet''s syndrome, a rare association in theliterature.     

Sweet's syndrome in acute myelogenous leukemia presenting as periorbital cellulitis with an infiltrate of leukemic cells

Sweet's syndrome is characterized by the abrupt onset of fever, neutrophilic leukocytosis, and erythematous, tender pseudovesiculated plaques or nodules that respond readily to corticosteroid therapy. It is usually distinguished by the presence of mature neutrophils on histopathologic examination. We describe a 38-year-old man with acute myelogenous leukemia who had an erythematous vesicular eruption of the left eye develop that resembled cellulitis. A biopsy specimen revealed a dermal infiltrate of mature neutrophils and immature myeloblastic precursors. He later had hemorrhagic pseudovesiculated plaques develop bilaterally on his hands. A biopsy specimen again revealed abundant neutrophils with immature forms. A similar eruption developed at the site of a Hickman catheter placement 4 months later. His skin lesions responded rapidly to oral corticosteroids. This case is unique in that his initial presentation of Sweet's syndrome resembled orbital cellulitis that was characterized by immature myeloid precursors on histopathology.     

Sweet's syndrome

A patient aged 50 with Sweet's syndrome combined with renal diseases is described. The clinical and pathomophological picture of the disease is described in detail. The skin process regressed after left percutaneous nephrostomy performed for the left ureter obstruction and after antibiotic and depuration therapy.     

Sweet's syndrome

A series of 10 cases of Sweet's syndrome observed during a period of 3 years in Eastern parts of Libya is reported. All the patients were females. Fever and peripheral neutrophilia were not found in all these cases. Dapsone was found to be very effective in the cases in which it was tried.     

Melkersson-Rosenthal syndrome masquerading as tuberculoid leprosy

A case of Melkersson-Rosenthal Syndrome is reported in a middle aged woman. Her skin lesion (cheilitis granulomatosa) resembled tuberculoid leprosy, clinically and histopathologically.     

Nitrofurantoin-associated Sweet's syndrome

A 53-year-old woman was seen for arthralgias, fever, and a painful rash developing at the end of a 7-day course of nitrofurantoin for a urinary tract infection. Her only other medication was naproxen, which was started after the onset of symptoms. Initial biopsy showed microscopic changes suggestive of a toxic eruption, but within 3 days the clinical signs and symptoms typical of Sweet's syndrome evolved. A repeat biopsy showed microscopic features characteristic of that diagnosis. The patient subsequently cleared with prednisone therapy. We report this patient as a case consistent with drug-induced Sweet's syndrome induced by nitrofurantoin.