Acute febrile neutrophilic dermatosis associated with JAK-2 positive myeloproliferative disorder.
We present a case of a 77-year-old man with a history of myeloproliferative disorder. He was admitted with a 2-week history of erythaema, swelling and significant pain of the right forearm following a mechanical fall at home, which had caused a skin laceration. During his admission, he developed ongoing intermittent fever and persistently elevated C reactive protein, and total white cell count. Initially, he was treated with antibiotics for suspected cellulitis. However, symptoms continued to progress, making a suitable management plan challenging. Wound swabs, blood cultures and viral PCR did not confirm infection. A punch biopsy of a skin lesion on the forearm was performed. The histology demonstrated a dense infiltrate of neutrophils and neutrophilic debris in keeping with acute febrile neutrophilic dermatosis (Sweet's syndrome). He was treated with oral steroids and after that he had a complete resolution of symptoms. However, he required a period of rehabilitation before returning home.
Forth Valley Royal Hospital, Larbert, UK.
Dean
D
Smyth
Department of Medicine, NHS Forth Valley & University of Edinburgh, Larbert, UK.
Jey
J
Selwyn
D000368:Aged; D001706:Biopsy; D006801:Humans; D053614:Janus Kinase 2 / Q000378:metabolism*; D008297:Male; D009196:Myeloproliferative Disorders / Q000150:complications* / Q000378:metabolism; D020556:Neutrophil Infiltration; D009504:Neutrophils; D012867:Skin / Q000473:pathology*; D016463:Sweet Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism / Q000473:pathology
C507924:JAK2 protein, human; D053614:Janus Kinase 2