title: Vascular inflammation (vasculitis) in sweet syndrome: a clinicopathologic study of 28 biopsy specimens from 21 patients.
abstract: BACKGROUND
  Sweet syndrome is characterized by painful, erythematous plaques of rapid onset accompanied by fever. Absence of vasculitis is a histologic criterion for diagnosis. However, recent reports suggest that vasculitis should not exclude the diagnosis. We hypothesized that vasculitis can occur in Sweet syndrome and that it represents an epiphenomenon rather than a primary immune-mediated process.
  
  
  METHODS
  Skin biopsy specimens from patients with Sweet syndrome were reviewed to determine the prevalence of vasculitis. The clinicopathologic features of cases with vasculitis were evaluated for statistically significant associations. Specimens with vasculitis underwent immunofluorescence staining.
  
  
  METHODS
  University department of dermatology, university hospital, and private practice.
  
  
  METHODS
  Medical records and biopsy specimens of 21 patients meeting diagnostic criteria for Sweet syndrome were reviewed.
  
  
  METHODS
  None.
  
  
  RESULTS
  The prevalence of vasculitis was 29% (6 of 21 patients). There was a significant association of vasculitis with lesions of longer duration (P =.02). Vascular immunoglobulin and complement could not be demonstrated in cases of Sweet syndrome with vasculitis.
  
  
  CONCLUSIONS
  Vasculitis is not a primary, immune-mediated process in Sweet syndrome but occurs secondary to noxious products released from neutrophils. Blood vessels in lesions of longer duration are more likely to develop vasculitis than those of shorter duration because of prolonged exposure to noxious metabolites. Vasculitis does not exclude a diagnosis of Sweet syndrome.
authors.affiliation: Department of Pathology, University of Louisville School of Medicine, 310 E Broadway, Louisville, KY 40202, USA.
authors.forename: Janine C
authors.initials: JC
authors.lastname: Malone
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Slone
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Wills-Frank
authors.forename: Paul K
authors.initials: PK
authors.lastname: Fearneyhough
authors.forename: Sheron C
authors.initials: SC
authors.lastname: Lear
authors.forename: L Jane
authors.initials: LJ
authors.lastname: Goldsmith
authors.forename: Antoinette F
authors.initials: AF
authors.lastname: Hood
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Callen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology; D016463:Sweet Syndrome / Q000150:complications*; D013997:Time Factors; D014657:Vasculitis / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology