Dermatologic Events

Neutrophilic dermatosis, including Sweet's syndrome and pyoderma gangrenosum, are rare events that have been reported in patients receiving chemotherapy with filgrastim support (3). With the increased use of filgrastim, the reporting incidence of these events has not dramatically increased. Neutrophilic dermatosis is approx <1 in 33,000 patients. Sweet's syndrome has been identified as a paraneoplastic syndrome seen in the patient population that typically receives filgrastim. Although filgrastim administration was temporally associated in several of the cases reported, its role in the pathogenesis of this syndrome is uncertain. In these reported cases, it is doubtful that filgrastim induced Sweet's syndrome, as these cases are similar to those reported in the literature in patients who were not receiving filgrastim or any other cytokines, and in a few reported cases other drugs were identified as co-suspect. It has been suggested that the pathogenesis of Sweet's syndrome may be secondary to an inappropriate secretion of one or more endogenous cytokines (5). Whether exogenous administration of filgrastim participates directly or indirectly in the development of Sweet's syndrome remains speculative.

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