A child with fever had multiple skin lesions, and on microscopic examination the skin lesions are seen to have neutrophilic and histiocytic infiltration in the dermis. What is the diagnosis?: (A) Sweet syndrome, (B) Behchet's syndrome, (C) Pyoderma gangrenosum, (D) Juvenile dermatosis
Answer is A. Sweet syndrome (Acute febrile neutrophilic dermatosis) Skin manifestations: Tender red papules, nodules and eventually plaques distributed over the head, neck, upper trunk and upper arms. Diagnostic criteria for Sweet syndrome Major Acute onset of typical lesions Histopathological findings : Neutrophilic and histiocytic infiltration in the dermis. Minor Fever >38degC Association with malignancy, inflammatory disorder or pregnancy, or antecedent UI or GI infectionExcellent response to systemic coicosteroids. Abnormal laboratory values at presentation (3/4 required: ESR >20 mm; leukocytes >8000; neutrophils>70%;elevated C-reactive protein) DOC: Oral Coicosteroids.