[CASE-STUDY] Ulcerated zosteriform nodules in adenocarcinoma of the colon.
This is a case of a 56-year-old Hispanic man with a history of adenocarcinoma of the colon (a colorectal/bowel cancer) who presented with a case of HISTIOCYTOID SWEET'S SYNDROME (HSS) that mimicked a zosteriform cutaneous metastasis. Cutaneous metastasis refers to the growth of cancer cells in the skin originating from an internal cancer. Zosteriform is a distribution or pattern of skin lesions most commonly seen in herpes zoster and zosteriform herpes simplex.
HSS is a histological variant of Sweet's syndrome (SS). This means that in patients with HSS, their biopsy results show something different from what you would normally expect to find.
In SS, mature white blood cells called neutrophils accumulate in the tissues. In HSS, immature myeloperoxidase-positive cells and not mature neutrophils can be seen. Myeloperoxidase is an enzyme that’s abundantly expressed in neutrophils.
The immature cells in HSS can be mistaken for histiocytes; immune cells that destroy foreign substances and help fight infection. Sometimes, real (authentic) histiocytes may also be present.
35-55% of HSS cases have developed secondary to cancer.
Garcia, A., Usman, A., Sturgeon, A. and Tarbox, M. (2020) Ulcerated zosteriform nodules in adenocarcinoma of the colon.
Proceedings: Baylor University Medical Center, Jun 1;33(4):637-638 (PMC) ncbi.nlm.nih.gov/pmc/articl...