DR. SUBHASHINI.B., MD,DCP

ASST.PROF

DEPT OF PATHOLOGY

• We received excision biopsy from the skin lesion over flexor aspect of forearm from a

35yr male patient.

• History- c/o multiple painful red raised lesions all over the body associated with fever since 10 days

• O/E- Multiple well defined erythematous tender papulo nodules and plaques noted over the thighs, both fore arms , anterior & posterior aspect of trunk and face.

DIFFERENTIAL DIAGNOSIS were given as 1) Sweet’s syndrome 2)Lepromatous leprosy with ENL (type 2 reaction) 3)Sarcoidosis MACROSCOPIC EXAMINATION- Received skin covered soft tissue bit measuring 0.6 x 0.2x 0.3 cm. whole tissue was processed

• MICROSCOPY

HPE REPORT – BIOPSY NO 4257/17 - Sections studied show surface squamous epithelium with focal liquefactive degeneration

of basal layer.

- Dermis shows perivascular and periappendigeal lymphohistiocytic infiltrate with

occasional neutrophils and areas of edema.

-There are dilated blood vessels with endothelial swelling.

-Subcutaneous tissue shows inflammatory infiltrate composed of lymphocytes and

histiocytes.

DIAGNOSIS- F/S/O Sweet’s syndrome with Atypical histology.

SWEET’S SYNDROME ( ACUTE NEUTROPHILIC DERMATOSIS)

HISTOPATHOLOGY • -Dense perivascular infiltrate composed largely of neutrophils is seen in band like

• distribution throught out the papillary dermis.

• -Some of the neutrophils may show nuclear fragmentation( leukocytoclasis).

• -In addition infiltrate may contain scattered lymphocytes and histiocytes and occasional

• eosinophils.

• -Vasodilatation and swelling of endothelium is seen along with edema of upper dermis.

SWEET’S SYNDROME OUR CASE

SWEET’S SYNDROME OUR CASE

SWEET’S SYNDROME OUR CASE

• ENL( ERYTHEMA NODOSUM LEPROSUM) OUR CASE

• ENL( ERYTHEMA NODOSUM LEPROSUM) OUR CASE

• ENL( ERYTHEMA NODOSUM LEPROSUM) OUR CASE

• SARCOIDOSIS OUR CASE

• SARCOIDOSIS OUR CASE

THANK YOU