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Case Reports
. 2024 Oct 9:11:1468712.
doi: 10.3389/fmed.2024.1468712. eCollection 2024.

Cryptococcoid Sweet syndrome: a case report

Martina Volonté  1 , Giacomo Fiandrino  2 , Camilla Vassallo  1 , Stefania Barruscotti  1   3 , Chiara Giorgini  1 , Carlo Francesco Tomasini  1   3 , Valeria Brazzelli  1   3
Affiliations
Case Reports

Cryptococcoid Sweet syndrome: a case report

Martina Volonté et al. Front Med (Lausanne). .

Abstract

Cryptococcoid Sweet syndrome (cSS) is a recently described clinical and histological variant of Sweet syndrome (SS). Its cutaneous presentation is similar to the classical form of SS but it includes atypical findings, such as capsular and yeast-like structures on microscopy that are reminiscent of Cryptococcus species. However, in cSS, fungal staining and cultural examination are negative, whereas myeloperoxidase (MPO) staining on biopsy specimens is typically positive. Due to the rarity and the diagnostic challenge represented by this disease, its extracutaneous involvement, and the latency in its diagnosis, this condition is frequently associated with poor prognosis. In this study, we report the case of a cSS patient with a positive outcome.

Keywords: Sweet syndrome; acute febrile neutrophilic dermatosis; cryptococcoid Sweet syndrome; cryptococcoid acute febrile neutrophilic dermatosis; neutrophilic dermatosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(a) Clinical appearance of the face, showing extensive necrotic tissue involving the middle and nasal area and discrete necrotic nodular lesions on the forehead and cheeks. Note nodular necrotic lesion on the lips. (b) Clinical appearance of lesions on the chest: edematous hemorrhagic papulo-pustules with tendance to punched-out ulceration. (c) Clinical appearance of lesions on the right arm: bullous hemorrhagic nodules showing umbilicated morphology with tendance to punched-out ulceration. (d) Clinical appearance of the face 10 days after introducing high-dosage systemic corticosteroids, with great improvement of lesions without scarring. (e) Clinical appearance of the right arm approximately 20 days after the introduction of high-dosage systemic corticosteroids, with almost complete remission without scarring.
Figure 2
Figure 2
(a) Hematoxylin-eosin, original magnification 2.5×: diffuse dermal cellular infiltrate. (b) Hematoxylin-eosin, original magnification 60×: rounded basophilic bodies surrounded by clear vacuolated spaces, admixed within mature polymorphous nucleated neutrophils. (c) Myeloperoxidase (MPO) staining (positive), original magnification 40×. (d) Grocott methenamine silver (GMS) staining (negative), original magnification 60×.
Figure 3
Figure 3
Timeline of the episode of care.
See this image and copyright information in PMC

References

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