THE SWEET SYNDROME DURING THERAPY WITH GRANULOCYTE COLONY-STIMULATING FACTOR

A 41-year-old woman with recently diagnosed breast cancer developed the Sweet syndrome during therapy with granulocyte colony-stimulating factor (G-CSF; filgrastim). This patient developed leukopenia during neoadjuvant combination chemotherapy and was subsequently treated with G-CSF. After a brisk recovery of her neutrophil count, the patient developed fever and an erythematous plaque on her thigh, followed by additional lesions. Examination of a skin biopsy specimen confirmed the diagnosis of the Sweet syndrome. The lesions resolved rapidly in the absence of further G-CSF therapy. To our knowledge, this the first unequivocal, biopsy-proven case of the Sweet syndrome to occur during G-CSF therapy. This case suggests that endogenous G-CSF may be involved in the pathogenesis of the Sweet syndrome.