新医学Issue(11)：772-775,4.DOI:10.3969/g.issn.0253-9802.2014.11.017
骨髓增生异常综合征并发急性发热性嗜中性皮病一例
Myelodysplastic syndrome complicated with acute febrile neutrophilic dermatosis:one case report
曾芸馨 1李旭东 1张競文 1林东军1
作者信息
- 1. 510630 广州，中山大学附属第三医院血液科
- 折叠
摘要
Abstract
Myelodysplastic syndrome (MDS )is a type of heterogeneous clonal hematopoiefic stem cell disease. A minority of MDS patients could be complicated with acute febrile neutrophilic dermatosis (Sweet's syndrome,SS),mainly characterized by asymmetric painful red papula,node and plaque,andpro-gresses into pustule during the advanced stage. Meanwhile,signs of fever,leukocytosis and accelerated eryth-rocyte sedimentation could occur. Skin pathological biopsy revealed infiltrated matureneutrophilic leukocytes scattering across superficial dermal layer. Glucocorticoid treatment was effective whereas anti-infectious therapy yielded no efficacy. MDS complicated with SS is likely to progress into acute myeloid leukemia with poor prog-nosis. In this article,we reported one MDS case complicated with SS after receiving chemotherapy via implant-able venous access port. The course of chemotherapy was successful,whereas cutaneous infection accompanied by persistent high fever was observed in the implanted site of venous access port. Painful red papula was found above the skin incision of the thoracic wall. Anti-infectious therapy yielded no efficacy. Skin biopsy revealed the signs of neutrophilic leukocyte infiltration into superficial dermal layer. The patient was diagnosed with MDS complicated with SS. Body temperature declined to normal level and the skin wound was healed following glu-cocorticoid administration. Subsequent follow-up demonstrated that the status of MDS was in complete re-sponse. Consequently,the possibility of MDS complicated with SS should be considered for those presenting with fever,painful red papula and no response towards anti-infectious therapy. Skin biopsy should be improved to make early diagnosis and deliver early treatment.关键词
急性发热性嗜中性皮病/骨髓增生异常综合征/皮肤感染Key words
Acute febrile neutrophilic dermatosis/Myelodysplastic syndrome/Skin infection引用本文复制引用
曾芸馨,李旭东,张競文,林东军..骨髓增生异常综合征并发急性发热性嗜中性皮病一例[J].新医学,2014,(11):772-775,4.
