วันศุกร์ที่ 13 สิงหาคม พ.ศ. 2553

720. Sweet's syndrome/suspect

ชาย 53 ปี มีไข้ 1 สัปดาห์และมี skin lesion ดังนี้โดยพบมากที่แขนขาและคอ คิดถึงอะไร มีความสำคัญอย่างไร รักษาอย่างไร (ก่อนหน้านี้แข็งแรงดี)

Click ที่ภาพเพื่อขยายขนาด

สงสัย Sweet's syndrome
Definition: Sweet, working in Plymouth in 1964, described a disease with four features: fever; leukocytosis; acute, tender, red plaques; and a papillary dermal infiltrate of neutrophils. This led to the name acute febrile neutrophilic dermatosis. Larger series of patients showed that fever and neutrophilia are not consistently present.[citation needed] The diagnosis is based on the two constant features, a typical eruption and the characteristic histologic features;[citation needed] thus the eponym "Sweet's syndrome" is used.
Cause: can be classified based upon the clinical setting in which it occurs: classical or idiopathic Sweet's syndrome (SS), malignancy-associated SS, and drug-induced SS.
Clinical manifestations
Acute, tender, erythematous plaques, nodes, pseudovesicles and, occasionally, blisters with an annular or arciform pattern occur on the head, neck, legs, and arms, particularly the back of the hands and fingers. The trunk is rarely involved. Fever (50%); arthralgia or arthritis (62%); eye involvement, most frequently conjunctivitis or iridocyclitis (38%); and oral aphthae (13%) are associated features.[citation needed] Differential diagnosis includes erythema multiforme, erythema nodosum, adverse drug reaction, and urticaria.[citation needed] Recurrences are common and affect up to one third of patients
Treatment: Systemic corticosteroids (prednisone 0.5 to 1.5 mg/kg of body weight per day) produce rapid improvement and are the “gold standard” for treatment

ผลตรวจ gram stain: numerous neutrophil, not found bacteria or fungus, Tzanck smear: not found multinucleate giant cell

http://en.wikipedia.org/wiki/Sweet's_syndrome

ไม่มีความคิดเห็น:

โพสต์ความคิดเห็น