Necrotizing neutrophilic dermatosis: A diagnostic challenge with a need for multi-disciplinary recognition, a case report
Necrotizing neutrophilic dermatosis: A diagnostic challenge with a need for multi-disciplinary recognition, a case report
复制标题
DOI：
10.1016/j.amsu.2020.07.037
复制
发表时间：
2020-09-01
影响因子：
1.7
通讯作者：
Barlev, Danny
中科院分区：
文献类型：
--
作者：
Gowda, Asha;Christensen, Luisa;Barlev, Danny
简介：坏死性嗜神经性皮肤病在临床上与坏死性筋膜炎相似，因此对诊断和治疗提出了挑战。由于他们相似的介绍，误诊和不适当或延误治疗是可能的。介绍的情况下：我们讨论的情况下，一名妇女与急性髓细胞白血病谁提出发烧，寒战，咳嗽，腿部伤口。在她被推测患有坏死性筋膜炎后，她接受了下肢截肢术;然而，症状持续存在。她最终被诊断为坏死性Sweet综合征，并进行了治疗，临床症状明显改善。讨论：坏死性嗜中性皮肤病和坏死性筋膜炎，严重影响皮肤，并与快速进展的全身功能，包括发热，寒战，白细胞增多，炎症标志物升高。最近的皮肤病学文献讨论了这些相似性和适当的管理方法;然而，至关重要的是，内科和外科亚专科对坏死性嗜中性皮肤病及其临床表现、诊断方法以及治疗干预措施有一个了解。熟悉这个实体可以减轻误诊，发病率和mortality.Conclusion的风险：与此报告，我们试图审查的功能，提示和援助的诊断坏死性嗜中性粒细胞性皮肤病，以帮助防止显着和可避免的发病率。
Introduction: Necrotizing neutrophilic dermatoses can clinically resemble necrotizing fasciitis and therefore pose a diagnostic and therapeutic challenge. Given their similar presentations, misdiagnosis and inappropriate or delayed treatments are possible.Presentation of case: We discuss the case of a woman with acute myeloid leukemia who presented with fevers, chills, cough, and a leg wound. She underwent amputation of her lower extremity after she was presumed to have necrotizing fasciitis; however, symptoms persisted. She was ultimately diagnosed with and treated for necrotizing Sweet's syndrome with notable clinical improvement.Discussion: Both, necrotizing neutrophilic dermatoses and necrotizing fasciitis, grossly affect the skin and are associated with rapidly progressing systemic features including fevers, chills, leukocytosis, and elevated inflammatory markers. Recent literature in dermatology addresses these similarities and the appropriate approach to management; however, it is critical that medical and surgical subspecialties have an understanding of necrotizing neutrophilic dermatoses and their clinical presentations, diagnostic approaches, as well as therapeutic interventions. Familiarity with this entity can mitigate the risk of misdiagnosis, morbidity, and mortality.Conclusion: With this report, we seek to review the features that are suggestive of and aid in the diagnosis of necrotizing neutrophilic dermatoses to help prevent significant and avoidable morbidity.