SWEET'S SYNDROME.

Sweet's syndrome, otherwise known as acute febrile neutrophilic dermatosis, is a rare disorder and potential complication of G-CSF administration. Though the disease pathophysiology is not entirely understood, an underlying neutrophil-mediated hypersensitivity reaction is believed to play a central role. Approximately 20-25% of patients with Sweet's syndrome have an underlying, typically hematologic malignancy. Sweet's syndrome management poses unique practice issues for the oncology nurse. This presentation will educate nurses in the clinical presentation, identification and management of Sweet's syndrome by looking at different case studies. Early identification, intervention and treatment applications are necessary to effectively heal the patient while diminishing their risk for infection and controlling pain. The nursing care matrix includes early identification of lesion manifestations, ensuring appropriate dermatological and wound care consults, administration of suitable treatments and symptom management. While standard medication therapy is corticosteroids, other documented effective treatments include potassium iodide, dapsone, indomethacin, colchicine, and cyclosporine. Skin biopsy confirms the diagnosis of Sweet's syndrome, with rapid improvement in both symptoms and dermatological abnormalities after initiation of systemic steroid therapy. Antibiotic treatment proves ineffective; therefore proper diagnosis is critical for appropriate patient management. Appropriate wound care performed by nursing is imperative to preventing infection. Pain control also remains a priority in these patients. Early identification of this rare complication and appropriate treatment applications are key in managing Sweet's syndrome. Monitoring infectious complications, effective pain management interventions and the administration and response to the poly-pharmaceuticals are important nursing outcome measures that will facilitate treatment planning and recovery. The implications of Sweet's syndrome for oncology nurses are significant. While administration of corticosteroid therapy in malignancy-associated Sweet's syndrome often promptly resolves symptoms and lesions, early identification is important. In addition, identification of Sweet's syndrome recurrences could also be indicative of recurrence of the malignancy. It is necessary to distinguish Sweet's syndrome from other skin disorders, such as herpes simplex and varicella zoster viruses or leukemia cutis, to avoid unnecessary use of antimicrobial or other therapies. Sweet's syndrome practice findings must be added to the growing body of oncology nursing symptom management evidence to guide further nursing practice. [ABSTRACT FROM AUTHOR]

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