Track

Clinical Studies

Abstract

Neutrophilic dermatoses (ND) often present with clinical, laboratory, and histologic features that overlap with cutaneous infection. The current diagnostic criteria for Sweet syndrome, the most common neutrophilic dermatosis, include abrupt onset of tender plaques, histologic neutrophilic infiltrates, and minor features such as fever, identifiable triggers, elevated inflammatory markers, and response to corticosteroids. Cutaneous infections may also fulfill these same diagnostic criteria; however, this overlap has not been well characterized in the literature. This study aims to identify clinical, laboratory, and histopathologic features that may distinguish sterile ND from cutaneous infections. A retrospective review was performed on cases of “neutrophilic dermatosis”.  Cases were classified as sterile ND or infection based on culture and clinical correlation, and statistical comparisons were performed to identify significant differences between groups. Of the 37 cases reviewed, 21 were determined to be sterile ND, including 13 classified clinically as Sweet syndrome. Sixteen cases were classified as infectious, of which 14 had tissue cultures obtained, including 9 cases which grew a pathogenic organism. No statistically significant differences were observed in leukocyte, neutrophil, or lymphocyte counts, neutrophil-to-lymphocyte ratio, c-reactive protein, or erythrocyte sedimentation rate. Histologic features examined included epidermal changes, papillary dermal edema, pattern, depth, and extent of neutrophil infiltration, leukocytoclasia, organism stains, and tissue necrosis; detailed comparative histologic analysis is ongoing and will be presented in full at the conference. Findings from this study may clarify key histologic and diagnostic features, improve accuracy in distinguishing these entities, and reduce the risks associated with delayed or inappropriate treatment.