A 49-year-old white woman presented with a 1-week history of widespread skin lesions in May 2001. Red, painful lumps appeared on her left hip and subsequently involved her legs, chest, arms, and face. She had been experiencing episodes of fever and arthralgias since the onset of her eruption. Her medical history was remarkable in that she had been diagnosed with hairy cell leukemia (HCL) 8¼ years earlier. At that time she had moderate leukopenia and an enlarged spleen. Results of a bone marrow aspiration and a core biopsy revealed a normocellular marrow, but an increase in mature lymphocytes was noted throughout the marrow smears and core sections. An elective splenectomy had been performed and the histological finding, mononuclear cells infiltrating the red pulp, was morphologically consistent with HCL. After the operation, the patient's peripheral blood cell count became normal and she was declared in complete hematologic remission.
Levy RM, Junkins-Hopkins JM, Turchi JJ, James WD. Sweet Syndrome as the Presenting Symptom of Relapsed Hairy Cell Leukemia. Arch Dermatol. 2002;138(12):1551-1554. doi:10.1001/archderm.138.12.1551