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• W2172168569 abstract "Sweet's syndrome is generally self-limited and responds promptly to oral corticosteroid therapy. A middle-aged Thai woman presented with widespread tender, erythematous, edematous plaques on the trunk and extremities. A biopsy specimen demonstrated papillary dermal edema and a nodular and diffuse neutrophilic infiltrate without vasculitis; a diagnosis of Sweet's syndrome was made. The lesions responded promptly to oral prednisone. New skin lesions were noted during repeated attempts to taper the dose of prednisone. Complete blood cell counts during multiple episodes demonstrated an elevated neutrophil count without a left shift. Mild anemia was noted, but bone marrow examination findings were normal. Dapsone resulted in a good response initially, but the lesions recurred after several months, despite doses of 100 mg/d. The patient was treated with colchicine, 0.6 mg twice daily with good control of her skin lesions. Crops of lesions continued to occur as faint pink macules, but never evolved. Over the next 10 years, the patient required almost continuous colchicine treatment, with recurrence of tender skin lesions noted soon after discontinuation of the medication. Thirteen years after the onset of her skin lesions, the patient reports that her general health is good, and she has not experienced any systemic disease. Skin lesions continue to occur with regularity, but are now milder with little tenderness. She is no longer taking colchicine. Recurrences of Sweet's syndrome are common, but our patient's history of nearly unremitting skin disease over many years is unusual. The lesions were symptomatic, and the patient sought treatment. Colchicine provided effective long-term relief. Diarrhea and cramping were noted during the first few days of therapy, but the drug was well tolerated during the remainder of a prolonged course of therapy. Roughly 10% of cases of Sweet's syndrome are associated with leukemia, and the diagnosis of leukemia may be delayed up to a year after the initial presentation of Sweet's syndrome. Patients with leukemia are more likely to be anemic.1Bourke JF Keohane S Long CC Kemmett D Davies M Zaki I et al.Sweet's syndrome and malignancy in the U.K.Br J Dermatol. 1997; 147: 609-613Crossref Scopus (95) Google Scholar Although our patient was anemic at the time of her initial presentation, a bone marrow examination was unremarkable, and she has remained well. Colchicine has been used successfully to treat vasculitis as well as other neutrophilic dermatoses, such as chronic bullous disease of childhood.2Zeharia A Hodak E Mukamel M Danziger Y Mimouni M Successful treatment of chronic bullous dermatosis of childhood with colchicines.J Am Acad Dermatol. 1994; 30: 660-661Abstract Full Text PDF PubMed Scopus (31) Google Scholar, 3Sullivan TP King LE Boyd AS Colchicine in dermatology.J Am Acad Dermatol. 1998; 39: 993-999Abstract Full Text Full Text PDF PubMed Scopus (79) Google Scholar Maillard et al4Maillard H Leclech C Peria P Avenel-Audran M Verret JL Colchicine for Sweet's syndrome: a study of 20 cases.Br J Dermatol. 1999; 140: 565-566Crossref PubMed Scopus (50) Google Scholar described short-term use of colchicine in 20 patients with Sweet's syndrome. Dapsone has also been used successfully, and good responses to agents such as indomethacin, pentoxifylline, metronidazole, cyclosporine, potassium iodide, doxycycline, and interferon alfa have also been noted in anecdotal reports.5Jeanfils S Joly P Young P Le Corvaisier-Pieto C Thomine E Lauret P Indomethacin treatment of eighteen patients with Sweet's syndrome.J Am Acad Dermatol. 1997; 36: 436-439Abstract Full Text PDF PubMed Scopus (62) Google Scholar, 6Cohen PR Holder WR Pentoxifylline for Sweet's syndrome.J Am Acad Dermatol. 1995; 32: 533-535Abstract Full Text PDF PubMed Scopus (13) Google Scholar, 7Banet DE McClave SA Callen JP Oral metronidazole, an effective treatment for Sweet's syndrome in a patient with associated inflammatory bowel disease.J Rheumatol. 1994; 21: 1766-1768PubMed Google Scholar, 8Bianchi L Masi M Hagman JH Piemonte P Orlandi A Systemic interferon-alpha treatment for idiopathic Sweet's syndrome.Clin Exp Dermatol. 1999; 24: 443-445Crossref PubMed Scopus (17) Google Scholar, 9von den Driesch P Steffan C Zobe A Hornstein OP Sweet's syndrome—therapy with cyclosporine.Clin Exp Dermatol. 1994; 19: 274-277Crossref PubMed Scopus (36) Google Scholar, 10Bourke JF Berth-Jones J Graham-Brown RA Sweet's syndrome responding to cyclosporine.Br J Dermatol. 1992; 127: 36-38Crossref PubMed Scopus (39) Google Scholar, 11Smith HR Ashton RE Beer TW Theaker JM Neutrophil-poor Sweet's syndrome with response to potassium iodide.Br J Dermatol. 1998; 139: 555-556Crossref PubMed Scopus (19) Google Scholar, 12Demitsu T Tadaki T Atypical neutrophilic dermatosis on the upper extremity affected by postmastectomy lymphedema: report of 2 cases.Dermatologica. 1991; 183: 230-233Crossref PubMed Scopus (39) Google Scholar, 13Joshi RK Atukorala DN Abanmi A al Khamis O Haleem A Successful treatment of Sweet's syndrome with doxycycline.Br J Dermatol. 1993; 128: 584-586Crossref PubMed Scopus (47) Google Scholar, 14Brodkin RH Schwartz RA Sweet's syndrome with myelofibrosis and leukemia: partial response to interferon.Dermatology. 1995; 190: 160-163Crossref PubMed Scopus (28) Google Scholar Dapsone proved insufficient to control our patient's symptoms, whereas colchicine was well tolerated and provided long-term control of her disease. The views expressed are those of the authors and are not to be construed as official or as representing those of the Army Medical Department or the Department of Defense. Conflict of interest: None identified." @default.
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• W2172168569 title "Long-term suppression of chronic Sweet's syndrome with colchicine?" @default.
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