Sweet's syndrome from an Indian perspective: a report of four cases and review of the literature.
BACKGROUND
Sweet's syndrome or acute febrile neutrophilic dermatosis is not frequently reported from India. Four patients fulfilling clinico-pathologic criteria for Sweet's syndrome seen during May-August 2002 prompted us to review reports on Indian patients from the indexed literature.


METHODS
A PubMed and IndMed search for Sweet's syndrome revealed 11 reports appearing between 1985-2002 documenting 12 patients. The clinico-pathologic features, clinical course and treatment of all these 16 patients (including four new cases) were studied.


RESULTS
The study comprised 12 females and four males between 35 days to 57 years of age. There were four children of < 12 years. Ulcerated, crusted lesions in one and typical, erythematous, tender, papulo-nodulo-plaques and targetoid lesions with pseudovesiculation were observed in 13 other patients particularly involving head, neck and upper limbs. Extracutaneous Sweet's syndrome manifesting as gingival hyperplasia and myositis was seen in one patient each. All had simultaneous onset of cutaneous lesions, fever, headache and malaise. Ocular involvement was observed in four patients only. Associated hematoligic disorders recorded were myelodysplasia in three, polycythemia vera in one and leukemia in three patients respectively. Two of these patients had treatment with all-transretinoic acid and low-dose cytosine-arbinoside before onset of Sweet's syndrome. One patient each had symptoms of upper respiratory tract infection and history of minor injury prior to cutaneous lesions. Another patient had pregnancy induced self-limiting Sweet's syndrome. Leukocytosis was present in 11 patients. Three of four new patients had positive tests for antistreptolysin-O and C-reactive protein. Characteristics histologic features were recorded in specimens of all patients. Eleven patients responded to systemic corticosteroids. Colchicin or potassium iodide were effective in one patient each.


CONCLUSIONS
The overall clinico-pathologic and therapeutic spectrum of Sweet's syndrome in Indian patients does not appear to be different from its established picture.
Mahajan
Vikram K
VK
Department of Dermatology, Venereology and Leprosy, Indira Gandhi Medical College, Shimla, India.
Sharma
Nand Lal
NL
Sharma
Ramesh Chander
RC
D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D016463:Sweet Syndrome / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology*