Acute febrile neutrophilic dermatosis is a painful, raised erythema of the skin caused by neutrophilia and extensive infiltration of the superficial and middle layers of the dermis, accompanied by fever and damage to other organs, also known as Sweet syndrome. The disease often has an acute onset, is more common in summer and autumn, and predominantly affects middle-aged and older women. One to two weeks before the onset, flu-like upper respiratory infections, bronchitis, or tonsillitis often serve as precursor symptoms. The disease responds well to corticosteroid therapy, and symptoms generally improve with timely and appropriate treatment.

bubble_chart Clinical Manifestations

1. Fever, myalgia, and migratory pain in large joints; 2. Early rashes are mostly exudative erythema or papules; 3. The typical skin lesions are flat, raised, polycyclic, round, or oval erythema, often with pseudochickenpox-like granules or papillary projections at the edges, and occasionally dark red large blisters; 4. Conjunctival congestion, oral mucosal erosion, and ulcers.

bubble_chart Diagnosis

1. Acute onset, with upper respiratory tract infection symptoms prior to the disease; 2. The rash may present as exudative erythema, papules, and painful raised erythema; 3. Increased erythrocyte sedimentation rate (ESR), which correlates with systemic symptoms; peripheral blood WBC > 10×10⁹/L, with a significant increase in neutrophils; transient hematuria and proteinuria; 4. Strongly positive subcutaneous nodule tuberculin intradermal test; 5. Positive pathergy test; 6. Histopathological examination: Focal dense polymorphonuclear leukocyte infiltration in the upper and middle dermis and perivascular areas.

Treatment Principles 1. Identify and eliminate the disease cause, avoiding various inducing factors; 2. Nonspecific anti-allergic treatment; 3. Reduce capillary permeability and fragility; 4. Corticosteroid and immunosuppressant therapy; 5. Symptomatic supportive treatment.

Medication Principles 1. For mild cases, focus on oral administration of vitamin C, E, and moderate-dose corticosteroids; 2. For severe cases or those with damage to other organs, prioritize intravenous administration of moderate to high-dose corticosteroids, while ensuring supportive symptomatic treatment; 3. For cases with poor response to corticosteroid therapy, add dapsone or Root Leaf or Flower of Common Threewingnut polysaccharide tablets.

bubble_chart Cure Criteria

1. Cure: The rash completely disappears, with no fever or other discomfort; 2. Improvement: Most of the rash subsides, with no fever or other discomfort; 3. No recovery: The rash does not subside or new rashes appear, with persistent fever, arthralgia, or oral lesions.