Sweet’s syndrome associated with chronic myelogenous leukemia: Demonstration of leukemic cells within a skin lesion

We report a case of acute febrile neutrophilic dermatosis, Sweet’s syndrome, associated with chronic myelogenous leukemia (CML) in which we found rearrangement of the bcr gene in DNA obtained from a skin lesion as well as in blood DNA by Southern blot analysis. This indicated the presence of CML cells within the skin lesion. To our knowledge, this is the first report in which the presence of CML cells is shown within skin lesions of Sweet’s syndrome. In our patient, leukocyte alkaline phosphatase activities returned to normal levels when he was suffering from Sweet’s syndrome and decreased again to below normal levels after it subsided. Whether the normalization of leukocyte alkaline phosphatase activity is common among CML patients with Sweet’s syndrome remains to be determined. (J Am Acad Dermatol 1999;40:275-9.)