Sweet syndrome in patients with solid tumors.
BACKGROUND
Sweet syndrome (acute febrile neutrophilic dermatosis) may occur as a cutaneous paraneoplastic syndrome. This condition has been associated with hematologic malignancies and, to a lesser extent, with solid tumors.


METHODS
The authors report two patients with malignancy-associated Sweet syndrome: a 66-year-old man in whom the onset of Sweet syndrome preceded the diagnosis of an adenocarcinoma of unknown primary by 3 months and a 69-year-old woman in whom a workup after the appearance of Sweet syndrome skin lesions revealed an unsuspected recurrent squamous cell carcinoma of the larynx. The authors review the reports of the other 39 patients with solid tumor-associated Sweet syndrome that have been published in the world literature.


RESULTS
The most common malignancies were carcinomas of the genitourinary organs (37%), breast (23%), and gastrointestinal tract (17%). Typical clinical features and laboratory findings in these patients included tender erythematous plaques located on the upper extremities (97%); elevated erythrocyte sedimentation rate (95%); anemia (83%); fever (79%); and neutrophilia (60%). The symptoms and lesions of Sweet syndrome resolved after treatment with corticosteroids, potassium iodide, or colchicine. Sweet syndrome preceded the initial diagnosis of cancer or the detection of asymptomatic metastatic, persistent, or recurrent tumor, or a hematologic malignancy (in an individual with a previously diagnosed solid tumor) in 61% of the patients. In the other 39% of patients, diagnosis of Sweet syndrome followed the development of a solid tumor.


CONCLUSIONS
The search for a neoplasm of the genitourinary organs and breast cancer in women and a gastrointestinal tract carcinoma in men should be emphasized in the evaluation for a solid tumor in patients with Sweet syndrome without a prior diagnosis of malignancy.
Cohen
P R
PR
Department of Dermatology, University of Texas Medical School at Houston 77030.
Holder
W R
WR
Tucker
S B
SB
Kono
S
S
Kurzrock
R
R
D000230:Adenocarcinoma / Q000150:complications; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000150:complications; D008297:Male; D009369:Neoplasms / Q000150:complications*; D009382:Neoplasms, Unknown Primary / Q000150:complications; D016463:Sweet Syndrome / Q000150:complications* / Q000473:pathology