Abstract
Sweet syndrome is a rare condition characterized as a febrile neutrophilic dermatosis. We present an atypical presentation of Sweet syndrome in female patient in her late 80s, characterized by acute fever, concurrent pancytopenia, and a unique constellation of cutaneous findings consisting of painful papulonodular lesions and hemorrhagic bullae with compatible histopathology, underscoring the necessity for clinicians to consider acute myeloid leukemia with myelodysplasia-related changes as a potential comorbidity in Sweet syndrome, particularly in cases with comparable clinical features. This report is particularly significant as it demonstrates the rapid clinical deterioration and emergence of complications, culminating in an unfavorable outcome despite early therapeutic intervention. The infrequent reporting of this unique presentation highlights the need for further exploration of its diagnostic and management relevance in patients with Sweet syndrome who exhibit hemorrhagic bullae manifestations.