Résumé
Background@#Sweet syndrome is characterized by tender erythematous plaques and nodules with predominantly dermal neutrophilic infiltrates. Sweet syndrome is relatively rare in children and adolescents. To date, only a few cases have been reported in Korean literature. @*Objective@#The aim of this study was to investigate the clinical and histopathological features of Sweet syndrome in Korean children and adolescents. @*Methods@#A retrospective study was conducted on 15 pediatric patients (aged ＜18 years) who were diagnosed with Sweet syndrome between 1991 and 2019. We reviewed the clinical and histopathological features of Sweet syndrome. @*Results@#The age of the 15 patients ranged from 4 months to 17 years. Among the 15 patients with Sweet syndrome, nine patients were females and six patients were males. Most patients (80%) had lesions on the upper extremities. Fever and tenderness (60%) were the most commonly associated symptoms. Transient infections such as upper respiratory infection or gastroenteritis were the most common identifiable cause, observed in 40% of patients. Histopathologically, dermal neutrophilic infiltration was observed in all patients. All patients were treated with systemic corticosteroids and showed a good response, although 26.7% of the patients experienced symptom recurrence.During the follow-up period, there were no incidences of any complications or extracutaneous manifestations in the patients. @*Conclusion@#In contrast to previous reports of pediatric Sweet syndrome, female predominance was observed in this study. Transient infection was the most common factor. All patients responded well to systemic corticosteroid therapy without complications or extracutaneous manifestations during the follow-up period.
Résumé
Background@#Sweet syndrome is characterized by tender erythematous plaques and nodules with predominantly dermal neutrophilic infiltrates. Sweet syndrome is relatively rare in children and adolescents. To date, only a few cases have been reported in Korean literature. @*Objective@#The aim of this study was to investigate the clinical and histopathological features of Sweet syndrome in Korean children and adolescents. @*Methods@#A retrospective study was conducted on 15 pediatric patients (aged ＜18 years) who were diagnosed with Sweet syndrome between 1991 and 2019. We reviewed the clinical and histopathological features of Sweet syndrome. @*Results@#The age of the 15 patients ranged from 4 months to 17 years. Among the 15 patients with Sweet syndrome, nine patients were females and six patients were males. Most patients (80%) had lesions on the upper extremities. Fever and tenderness (60%) were the most commonly associated symptoms. Transient infections such as upper respiratory infection or gastroenteritis were the most common identifiable cause, observed in 40% of patients. Histopathologically, dermal neutrophilic infiltration was observed in all patients. All patients were treated with systemic corticosteroids and showed a good response, although 26.7% of the patients experienced symptom recurrence.During the follow-up period, there were no incidences of any complications or extracutaneous manifestations in the patients. @*Conclusion@#In contrast to previous reports of pediatric Sweet syndrome, female predominance was observed in this study. Transient infection was the most common factor. All patients responded well to systemic corticosteroid therapy without complications or extracutaneous manifestations during the follow-up period.
Résumé
Perforating granuloma annulare (PGA), a rare variant of granuloma annulare, is characterized by transepidermal elimination of altered collagen that clinically manifests an umbilicated papule with a central crust. It can be confused with papulonecrotic tuberculid (PNT) because of their similar appearance. Unlike PGA, PNT is usually related to tuberculosis infection with a typical histologic finding of wedge-shaped dermal necrosis. Here, we report the first Korean case of PGA mimicking PNT both clinically and histologically. A 43-year-old Korean woman presented with erythematous papules localized on the extensor surface of her limbs for one year. Some of these papules had a central umbilication or a crust. Regarding comorbidity, she had latent tuberculosis diagnosed with QuantiFERON®-TB Gold test about five months ago. She was on antituberculous medication. Initially, a diagnosis of papulonecrotic tuberculid accompanied by latent tuberculosis was considered. However, despite taking the antituberculous medication for five months, her skin lesions were not improved. Biopsy specimen from her arm lesion showed wedge-shaped area of necrosis in the dermis. Additionally, there were multiple focal mucin depositions and palisading granulomatous inflammation throughout the dermis. A diagnosis of PGA was made and she was treated with topical corticosteroid. After two weeks of applying topical corticosteroid, most of her skin lesions disappeared, leaving some hyperpigmented scars.