Lymphedema-associated neutrophilic dermatosis: Two cases of localized Sweet syndrome on the lymphedematous lower limbs

J Dermatol. 2016 Sep;43(9):1062-6. doi: 10.1111/1346-8138.13379. Epub 2016 Apr 21.

Abstract

Neutrophilic dermatosis on the site of lymphedema is a rare condition and considered as a localized and less severe variant of Sweet syndrome. Only 13 cases of this variant have been reported after mastectomy for breast cancer in the English-language published work. However, this condition has never been described on the lower limbs or from other causes of lymphedema. Herein, we report two cases of localized Sweet syndrome on the lymphedematous lower limbs: one occurred after radical hysterectomy, bilateral pelvic lymph node dissection and radiotherapy for cervical cancer; the other developed after radiotherapy for malignant melanoma on the right groin. Based on clinical and histological features, we suggest the name "lymphedema-associated neutrophilic dermatosis" for this underrecognized disease entity.

Keywords: corticosteroid; immunocompromised; lymphedema; neutrophilic dermatosis; radiotherapy.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Biopsy
  • C-Reactive Protein / analysis
  • Cephalosporins / therapeutic use
  • Female
  • Fever / etiology
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use
  • Humans
  • Hydrocortisone / administration & dosage
  • Hydrocortisone / therapeutic use
  • Hysterectomy / adverse effects*
  • Hysterectomy / methods
  • Infusions, Parenteral
  • Leukocytosis / blood
  • Lower Extremity
  • Lymphedema / etiology*
  • Melanoma / pathology
  • Melanoma / radiotherapy*
  • Middle Aged
  • Neoplasm Staging
  • Neutrophils / pathology
  • Prednisolone / administration & dosage
  • Prednisolone / therapeutic use
  • Radiotherapy / adverse effects*
  • Skin / pathology
  • Sweet Syndrome / blood
  • Sweet Syndrome / diagnosis*
  • Sweet Syndrome / drug therapy
  • Sweet Syndrome / etiology
  • Thrombocytopenia / blood
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery*

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • Glucocorticoids
  • C-Reactive Protein
  • Prednisolone
  • flomoxef
  • Hydrocortisone