A 20-year-old male, known case of AML is undergoing chemotherapy. The patient has a neutrophil count of 40, so he was staed on prophylactic antibiotics. Patient had a spike of fever today morning. Patient is also complaining of severe myalgias, joint pains and skin lesions.The new skin lesions are appearing in all body areas and are mildly painful.Biopsy of the skin lesion will most likely show: –

**Core Concept**
The patient in question is a 20-year-old male with Acute Myeloid Leukemia (AML) undergoing chemotherapy, presenting with fever, myalgias, joint pains, and skin lesions. This clinical presentation is characteristic of Sweet's syndrome, also known as acute febrile neutrophilic dermatosis.

**Why the Correct Answer is Right**
Sweet's syndrome is a rare skin condition characterized by the sudden onset of fever, neutrophilia, and tender skin lesions. In the context of AML, Sweet's syndrome can occur as a paraneoplastic phenomenon, indicating an immune response to the underlying malignancy. The skin lesions in Sweet's syndrome are typically tender, erythematous, and sometimes vesicular or bullous. The biopsy of these lesions would show a dense infiltrate of neutrophils in the dermis, often associated with a lichenoid or granulomatous reaction.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect as it does not accurately describe the histopathological findings in Sweet's syndrome. While Sweet's syndrome can involve a range of cellular infiltrates, the characteristic feature is the presence of neutrophils in the dermis.

**Option B:** This option is incorrect as it refers to a different skin condition altogether. Erythema multiforme is a distinct entity characterized by targetoid lesions, often associated with infections or medications.

**Option C:** This option is incorrect as it does not accurately describe the clinical presentation of Sweet's syndrome. While Sweet's syndrome can involve skin lesions, the lesions are typically tender and not described as "necrotic."

**Clinical Pearl / High-Yield Fact**
In patients with AML, Sweet's syndrome can occur as a paraneoplastic phenomenon, often associated with an immune response to the underlying malignancy. This clinical correlation is essential to recognize, as Sweet's syndrome can mimic other skin conditions and requires prompt diagnosis and treatment.

**Correct Answer: C.**

✓ Correct Answer: A. <img style="max-width: 100%" src=" />