Sweet Syndrome as the Presenting Symptom of Relapsed Hairy Cell Leukemia

December 2002 in “ Archives of Dermatology ”

Ross M. Levy, Jacqueline M. Junkins‐Hopkins, Joseph J. Turchi, William D. James

hairy cell leukemia Sweet syndrome skin lesions bone marrow biopsy 2-chlorodeoxyadenosine prednisone hematologic malignancies HCL skin condition cladribine

TLDR Sweet syndrome can be the only sign of hairy cell leukemia relapse.

In 2002, a 49-year-old woman with a previous diagnosis of hairy cell leukemia (HCL) developed Sweet syndrome, characterized by skin lesions, fever, and joint pain. Despite having normal blood cell counts, a bone marrow biopsy indicated a relapse of HCL with 12-15% leukemic cells. The patient was successfully treated with 2-chlorodeoxyadenosine and prednisone, which resolved the skin condition and normalized blood cell counts. This case highlighted Sweet syndrome as a potential sole indicator of HCL relapse, emphasizing the need to consider hematologic malignancies in Sweet syndrome patients even when blood counts appear normal.

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