Tests & Diagnosis
The diagnosis of acute febrile neutrophilic dermatosis (Sweet syndrome) is usually based on histopathologic examination by a qualified dermatopathologist, as the lab findings are commonly nonspecific.
- A complete blood count - Neutrophilia is often present
- Anemia and thrombocytopenia in patients with underlying malignancy is usual occurrence
- Blood count abnormalities should prompt investigation of bone marrow biopsy.
- (ESR) and CRP levels are elevated
- A urinalysis may show proteinuria and / or hematuria.
- Lesions can be cultured for bacteria, fungi, and mycobacteria to rule out infection.
- A chest radiograph should be obtained if the pulmonary symptoms are present
- Sweet's syndrome is the presenting sign of cancer in about two thirds of cases of cancer associated with Sweet syndrome. The presence of ulcerative lesions, oral lesions, abnormal platelet count or anemia should prompt the investigation of an underlying disease.
- 2 - [fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) is particularly useful in the assessment of myeloproliferative disorders, but also for the assessment of solid tumors, useful and successful represented the beginning of malignant tumors.
- The skin should be biopsied to confirm the diagnosis of acute febrile neutrophilic dermatosis (Sweet's syndrome).
- Bone marrow aspiration is indicated if the CBC is abnormal and should be considered in all cases of Sweet's syndrome with atypical bullous or ulcerative Sweet syndrome.
- Age appropriate cancer screening and assessment for inflammatory bowel disease to be carried out, if no other cause is found, particularly in patients with ulcerative lesions or bullous.