History: This elderly man has had these lesions on his hand for 4 weeks. No lesions elsewhere.They are tender and some appear to have ulcerated. He has a past history of Bowel cancer. He is also anaemic.
I think this is Sweet's syndrome but please exclude Sporotrichosis or other deep fungus. Specimens for histo and culture

Description: Dense infiltrate of neutrophils in the upper dermis

Comments: Sections show a biopsy of skin in which there is a dense infiltrate of neutrophils filling the upper dermis. There is a lesser infiltrate of neutrophils in the mid and deep dermis. There is no evidence of vasculitis. At the edge of the biopsy there is disruption of the epidermis with extension of the neutrophilic infiltrate through the epidermis into the stratum corneum. The features present are those of Sweet's syndrome.