An Unusual Case of Nonneutropenic Fever Associated With Myelodysplasia and Sweet's Syndrome

TL;DR

A 72-year-old woman with myelodysplasia and Sweet's syndrome showed improvement with steroid and decitabine treatment.

Contribution

This case highlights the rare association of myelodysplasia and Sweet's syndrome with nonneutropenic fever.

Findings

Skin biopsy confirmed Sweet's syndrome with neutrophilic infiltrate in the dermis and subcutis.

Decitabine therapy was initiated after a bone marrow biopsy confirmed myelodysplastic syndrome.

Systemic steroids successfully treated the patient's Sweet's syndrome symptoms.

Abstract

Sweet’s syndrome (SS) is a rare paraneoplastic condition characterized by skin lesions, fever, and leukocytosis. It is typically associated with hematological malignancies but is also linked to solid tumors, medications, and inflammatory diseases. The onset of SS can precede or coincide with the discovery of an undiagnosed cancer. Here, we present the case of a 72-year-old woman with neutropenic fever and an incidental nodule in the right breast. Skin biopsy revealed a neutrophilic infiltrate within the deeper dermis and likely subcutis, which is diagnostic for SS. Successful treatment with systemic steroids was administered, while the concurrent diagnosis of myelodysplastic syndrome led to the initiation of decitabine therapy following a bone marrow biopsy.

Figures