Korean J Intern Med.  2001 Sep;16(3):218-221.

Sweet's syndrome during the treatment of acute promyelocytic leukemia with all-trans retinoic acid

• Park CJ
• Bae YD
• Choi JY
• Heo PS
• Lee KS
• Park YS
• Lee JA

Abstract

All-trans retinoic acid (ATRA) is the standard induction treatment for acute promyelocytic leukemia (APL). Quite many ATRA-related side effects, including retinoic acid syndrome, were reported. So far, it has rarely been reported that Sweet's syndrome, characterized by fever, neutrophilia, painful erythematous cutaneous plaques, dense dermal infiltrates of mature neutrophils and rapid response to steroid therapy, is associated with ATRA. In the case that Sweet's syndrome associated with ATRA is found, physicians will have to face a great challenge over the possibility of infectious conditions. We present here a case of Sweet's syndrome associated with ATRA. A 35-year-old female with APL developed fever, painful erythematous cutaneous plaques on both cheeks, right wrist and both shins during induction chemotherapy with ATRA. A skin biopsy revealed a dense dermal infiltrate, consisting of mature neutrophils without vasculitis or cutaneous immunoglobulin deposits, which is compatible with Sweet's syndrome. Oral prednisone was administered and the lesions started to improve within 48 hours

Keyword

Sweet's syndrome; all-trans retinoic acid; acute promyelocytic leukemia

MeSH Terms

Adult
Biopsy, Needle
Case Report
Female
Follow-Up Studies
Human
Leukemia, Promyelocytic, Acute/diagnosis/*drug therapy
Prednisone/administration & dosage
Risk Assessment
Sweet's Syndrome/*chemically induced/drug therapy/*pathology
Tretinoin/*adverse effects/therapeutic use