Sweet syndrome in underlying malignancy

Sweet syndrome, also known as acute febrile neutrophilic dermatosis, was diagnosed in two patients. Patient A, a 68-year-old man, had had chronic lymphatic leukaemia for four years, with a recent relapse. Patient B, a 58-year-old man, had been diagnosed with renal cell carcinoma four years earlier. Both patients presented with general discomfort, high fever, neutrophilic leukocytosis and diffuse, non-tender maculopapular exanthema, partly blanching on applied pressure, and vesicles spread over the body. Patient A had clinical signs of a septic shock. In both patients, histological examination confirmed clinical suspicion of Sweet syndrome and both had a good response on prednisone. In patient B, progression of renal cell carcinoma was found more than a half year later. It is important to recognise the varied clinical picture of the rare disorder that is Sweet syndrome because it can lead to severe clinical illness, especially in patients with an underlying malignancy.