PMC6985142_01
Clinical and histopathological images of the patient before and after treatment. (a) Neck and upper chest with erythema and red papules. (b) Left forearm with raised, pseudovesicular cysts, and infiltrated plaques. (c) Hematoxylin-eosin (HE) staining of skin biopsy from papule at back of neck showing edema of hair follicle epithelial cells in the dermis, surrounded by eosinophils, lymphocytes, and neutrophils inflammatory infiltration. And neutrophils and eosinophils were seen migrated into the hair follicle epithelium (original magnification x100). (d) HE staining of skin biopsy from left forearm plaque showing obvious edema in the superficial dermis, neutrophils, and lymphocytes infiltrated diffusely in the superficial and middle layers of dermis, and nuclear sedimentation were present significantly (x100). (e) Neck and upper chest papules resolved completely. (f) Forearm with scars formation.
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F1
However, 3 weeks after the onset of ART, there were dense, red follicular papules with itching involving the face, neck and upper trunk, ranging from 2 to 5 mm in diameter (Figure 1a). She then developed painful, raised, infiltrated plaques, and pseudovesicular on her left forearm (Figure 1b). And neutrophils and eosinophils were seen migrated into the hair follicle epithelium (Figure 1c). Pathological examination of the left forearm biopsy confirmed the diagnosis of Sweet's syndrome with obvious edema in the superficial dermis, neutrophils and lymphocytes infiltrated diffusely in the superficial and middle layers of dermis, and nuclear sedimentation were present significantly (Figure 1d). On follow-up half month later, the follicular papules on face, neck and trunk were improved and about 1 month after the onset of treatment the plaques were also improved significantly (Figures 1e,f).