Generalised Pustulous Sweet’s Syndrome | Revista Clínica Española

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Rodríguez-Villa Lario, A.B. Piteiro-Bermejo, D. Vélez Velázquez" "autores" => array:3 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Rodríguez-Villa Lario" "email" => array:1 [ 0 => "anarvlario@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "A.B." "apellidos" => "Piteiro-Bermejo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "D." "apellidos" => "Vélez Velázquez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Síndrome de Sweet pustuloso generalizado" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2760 "Ancho" => 2924 "Tamanyo" => 829070 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "." ] ] ] "textoCompleto" => "The patient is a 68-year-old man with a personal medical history of type 2 diabetes mellitus and hypertension. He came to the emergency department for acute symptoms that had been ongoing for two days consisting of a generalized pruriginous skin rash associated with general malaise and fever.Upon physical examination, a varioloid skin rash consisting of erythematous papules and papule-vesicles was observed mainly on the trunk and neck with more pustular lesions and hemorrhagic vesicle-blisters on the face, palms, and soles of the feet. In the perioral area, there were periorificial pustular, crusty lesions that appeared similar to contagious impetigo (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A–D).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>The blood test performed in the emergency department revealed leukocytosis of 22,000 with neutrophilia. A skin biopsy was performed which showed small intraepidermal pustules and moderate interstitial neutrophilic infiltrates (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The histological diagnosis was neutrophilic dermatosis with pustular Sweet’s syndrome intraepidermal pustules.<elsevierMultimedia ident="fig0010"></elsevierMultimedia>Pustular Sweet’s syndrome (SS) is considered a rare variant of SS. The typical form of presentation of this variant is a localization on the hands, known as pustular neutrophilic dermatosis of the dorsal hands. Our case is a generalized pustular variant, an infrequent clinical picture. First-line treatment is systemic corticosteroids. It is necessary to screen for neoplastic hematologic diseases, solid tumors, inflammatory bowel disease, and rheumatic diseases, among others. It is also necessary to conduct a good anamnesis and physical examination in search of possible associated systemic manifestations." 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