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Palmoplantar Pseudovesicles: An Unusual Presentation of Sweet's Syndrome.

Bubna AK, Veeraraghavan M, Anandan S, Rangarajan S - Indian J Dermatol (2015 Jan-Feb)

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Sri Ramachandra University, Chennai, Tamil Nadu, India. E-mail: makarios70@gmail.com.

AUTOMATICALLY GENERATED EXCERPT
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Skin lesions of SS are typically tender, purple red edematous papules and nodules which give an illusion of vesiculation... The eruption favors the head, neck and the upper extremities with an asymmetric distribution... Other symptoms associated with SS include arthralgia, malaise, headache and myalgia... Diagnostic criteria for SS include, major criteria: (1) abrupt onset of typical cutaneous lesions and (2) histopathology consistent with SS... Minor criteria: (1) lesions preceded by one of the associated infections or vaccinations, accompanied by one of the associated malignancies or inflammatory disorders associated with drug exposure or pregnancy; (2) presence of fever and constitutional signs and symptoms; (3) leukocytosis and (4) excellent response to systemic corticosteroids. (At least 2 major and 2 minor criteria are needed to diagnose a patient with SS)... The lesions rapidly increased in size to reach the current status... There were no associated systemic symptoms... Physical examination revealed erythematous, edematous plaques over the finger tips and also involving the hypothenar eminences in a symmetrical pattern [Figure 1]... Over both the soles the plaques were more edematous than the palms mainly involving the medial aspect in a symmetrical pattern and giving an illusion of vesiculation [Figures 2 and 3]... SS can have a very rare presentation as highlighted in our patient... Apart from the palmoplantar involvement there were no other cutaneous findings in our patient... A bilateral symmetrical presentation, a localized involvement, absence of constitutional symptoms and asymptomatic cutaneous lesions should not deter us from keeping a diagnosis of SS in mind because of the unusual manner in which this disorder may sometimes present.

No MeSH data available.


Closer view demonstrating the psuedovesicles
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Figure 3: Closer view demonstrating the psuedovesicles

Mentions: Our patient was a 47-year-old female who presented to the Department of Dermatology with complaints of abrupt onset of slightly raised erythematous non tender skin lesions over the palms and the soles for the past 1 week. The lesions rapidly increased in size to reach the current status. There were no associated systemic symptoms. Her medical and family history was non-contributory. She was receiving no medications. She had no underlying disease such as hematologic malignancy, or inflammatory bowel disease. She was afebrile with no pallor. Physical examination revealed erythematous, edematous plaques over the finger tips and also involving the hypothenar eminences in a symmetrical pattern [Figure 1]. Over both the soles the plaques were more edematous than the palms mainly involving the medial aspect in a symmetrical pattern and giving an illusion of vesiculation [Figures 2 and 3]. A biopsy specimen taken from the lesion showed no epidermal changes. The dermis showed a diffuse nodular and perivascular neutrophilic infiltrate without evidence of vasculitis [Figures 4 and 5]. The laboratory studies revealed a normal erythrocyte sedimentation rate. Her white blood cells count was 13,000 cells/mm3 with 80% neutrophils. Her peripheral smear was normal. The hemoglobin level was 13 gm/dL and the platelet count was 200,000 cells/mm3. The result of serum electrolyte assessment, the renal and liver function panel and the urinalysis were normal. An ultrasound of the abdomen and pelvis showed no underlying abnormality. Based on the clinical and laboratory findings a diagnosis of SS was made. The patient was started on 20 mg of Prednisolone once daily for 2 weeks and 0.5 mg of Colchicine twice daily for 2 weeks. The lesions resolved without scarring. The patient was subsequently lost to follow up.


Palmoplantar Pseudovesicles: An Unusual Presentation of Sweet's Syndrome.

Bubna AK, Veeraraghavan M, Anandan S, Rangarajan S - Indian J Dermatol (2015 Jan-Feb)

Closer view demonstrating the psuedovesicles
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4318077&req=5

Figure 3: Closer view demonstrating the psuedovesicles
Mentions: Our patient was a 47-year-old female who presented to the Department of Dermatology with complaints of abrupt onset of slightly raised erythematous non tender skin lesions over the palms and the soles for the past 1 week. The lesions rapidly increased in size to reach the current status. There were no associated systemic symptoms. Her medical and family history was non-contributory. She was receiving no medications. She had no underlying disease such as hematologic malignancy, or inflammatory bowel disease. She was afebrile with no pallor. Physical examination revealed erythematous, edematous plaques over the finger tips and also involving the hypothenar eminences in a symmetrical pattern [Figure 1]. Over both the soles the plaques were more edematous than the palms mainly involving the medial aspect in a symmetrical pattern and giving an illusion of vesiculation [Figures 2 and 3]. A biopsy specimen taken from the lesion showed no epidermal changes. The dermis showed a diffuse nodular and perivascular neutrophilic infiltrate without evidence of vasculitis [Figures 4 and 5]. The laboratory studies revealed a normal erythrocyte sedimentation rate. Her white blood cells count was 13,000 cells/mm3 with 80% neutrophils. Her peripheral smear was normal. The hemoglobin level was 13 gm/dL and the platelet count was 200,000 cells/mm3. The result of serum electrolyte assessment, the renal and liver function panel and the urinalysis were normal. An ultrasound of the abdomen and pelvis showed no underlying abnormality. Based on the clinical and laboratory findings a diagnosis of SS was made. The patient was started on 20 mg of Prednisolone once daily for 2 weeks and 0.5 mg of Colchicine twice daily for 2 weeks. The lesions resolved without scarring. The patient was subsequently lost to follow up.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Sri Ramachandra University, Chennai, Tamil Nadu, India. E-mail: makarios70@gmail.com.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Skin lesions of SS are typically tender, purple red edematous papules and nodules which give an illusion of vesiculation... The eruption favors the head, neck and the upper extremities with an asymmetric distribution... Other symptoms associated with SS include arthralgia, malaise, headache and myalgia... Diagnostic criteria for SS include, major criteria: (1) abrupt onset of typical cutaneous lesions and (2) histopathology consistent with SS... Minor criteria: (1) lesions preceded by one of the associated infections or vaccinations, accompanied by one of the associated malignancies or inflammatory disorders associated with drug exposure or pregnancy; (2) presence of fever and constitutional signs and symptoms; (3) leukocytosis and (4) excellent response to systemic corticosteroids. (At least 2 major and 2 minor criteria are needed to diagnose a patient with SS)... The lesions rapidly increased in size to reach the current status... There were no associated systemic symptoms... Physical examination revealed erythematous, edematous plaques over the finger tips and also involving the hypothenar eminences in a symmetrical pattern [Figure 1]... Over both the soles the plaques were more edematous than the palms mainly involving the medial aspect in a symmetrical pattern and giving an illusion of vesiculation [Figures 2 and 3]... SS can have a very rare presentation as highlighted in our patient... Apart from the palmoplantar involvement there were no other cutaneous findings in our patient... A bilateral symmetrical presentation, a localized involvement, absence of constitutional symptoms and asymptomatic cutaneous lesions should not deter us from keeping a diagnosis of SS in mind because of the unusual manner in which this disorder may sometimes present.

No MeSH data available.