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Oral ulceration in newly diagnosed leukaemic patient with undiagnosed sweet's syndrome

From Volume 42, Issue 6, July 2015 | Pages 584-585

Authors

Daniel Brierley

BDS(Hons), MFDS

BDS (Hons), MFDS RCS (Ed), MFDS RCS (Eng), FRCPath, PhD, SFHEA, Senior Clinical Teacher and Honorary Consultant in Oral and Maxillofacial Pathology; School of Clinical Dentistry, University of Sheffield

Articles by Daniel Brierley

David N Slater

MB ChB, FRCPath

Consultant Pathologist, General Pathology, Royal Hallamshire Hospital, Sheffield

Articles by David N Slater

John Snowden

BSc(Hons), MBChB, MD, FRCP, FRCPath

Consultant Haematologist, Haematology, Royal Hallamshire Hospital, Sheffield

Articles by John Snowden

Debbie Holt

MBChB, BDS, FDS RCPS, PhD

SpR in Oral Medicine, Oral Medicine Unit, Charles Clifford Dental Hospital, Sheffield

Articles by Debbie Holt

Anne Hegarty

MSc (OM), MBBS, MFD RCSI, FDS RCS (OM)

Consultant and Honorary Senior Clinical Lecturer in Oral Medicine, Oral Medicine Unit, Charles Clifford Dental Hospital, Sheffield, UK

Articles by Anne Hegarty

Abstract

Sweet's syndrome is a relatively rare but important skin condition which can affect the oral cavity. Awareness of this reactive condition is important for dentists who work in hospitals, where it is most likely to present. This report summarizes one such case and aims to introduce the reader to Sweet's syndrome.

CPD/Clinical Relevance: Oral ulceration is a common condition occurring in medical inpatients for which oral and maxillofacial surgery and medicine senior house officers and specialists are often asked to review on the ward. An awareness of Sweet's syndrome is important as it is most likely to occur in this setting and may present with oral ulceration.

Article

In early 2011, a 53-year-old female patient with a 3-week history of oral ulceration was referred to Oral Medicine from Haematology at the Charles Clifford Dental Hospital. There was no history of ulceration before this episode. A few weeks previously she had presented to another hospital with a sore throat and skin lesions on her face, neck, legs and forearms. The patient had also been aware of ulcers on her palate and throat during this period. At this time, a full blood count showed haemoglobin to be 7.6g/dL, a raised WCC count of 48.9 x 109/L and neutrophil count of 22.5 x 109/L with blast cells on blood film examination (0.56 X 109/L). She had pyrexia during the following weeks, constant leukocytosis and low platelets ranging from 7 to 134 x 109/L. After extensive work-up she was diagnosed as having acute leukaemia.

Her previous medical history revealed that she had controlled hypertension and asthma, with an allergy to penicillin. She was a non-smoker and drank a minimal amount of alcohol. She worked as a school teacher and was married with two children.

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