Sweet outcome for a rare inflammatory condition (original) (raw)
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EP11 An unusual presentation of Sweet syndrome
Rheumatology
Background Sweet syndrome (acute febrile neutrophilic dermatosis) is a rare inflammatory disorder affecting individuals between the ages of 30 and 60. It is characterised by painful, edematous, and erythematous skin papules, plaques, or nodules. Fever and leukocytosis (neutrophilia) frequently accompany the skin lesions. A majority of cases are idiopathic but there is a significant proportion attributed to malignancy or medications. Our case is peculiar because of an unusual presentation of a 12-month history of undifferentiated inflammatory arthritis before manifestation as Sweet syndrome. The mainstay of treatment is corticosteroids, although spontaneous resolution has been reported. Treatment of an underlying medical cause may lead to an improvement in Sweet syndrome. Methods A 57-year old British male presented with a 1-year history of intermittent joint pain and swellings in both upper and lower limbs. He had been treated with short courses of oral corticosteroids for undiffere...
Sweet’s Syndrome: A Classical Presentation of a Rare Disease
Journal of Investigative Medicine High Impact Case Reports
Sweet’s syndrome, also known as acute febrile neutrophilic dermatosis, is a rare disorder that typically presents with rapid appearance of tender skin lesions accompanied by fever and leukocytosis with neutrophilia. Its pathogenesis is not fully understood. The syndrome is generally classified into classical, malignancy-associated, and drug-induced categories, each of which has its specific characteristics. In this article, we present a case of classical Sweet’s syndrome in a woman who presented with an acute viral illness.
Periodic Fever and Neutrophilic Dermatosis: Is It Sweet’s Syndrome?
Case Reports in Immunology, 2014
A 7-year-old boy with high grade fever (39 ∘ C) and warm, erythematous, and indurated plaque above the left knee was referred. According to the previous records of this patient, these indurated plaques had been changed toward abscesses formation and then spontaneous drainage had occurred after about 6 to 7 days, and finally these lesions healed with scars. In multiple previous admissions, high grade fever, leukocytosis, and a noticeable increase in erythrocyte sedimentation rate and C-reactive protein were noted. After that, until 7th year of age, he had shoulder, gluteal, splenic, kidney, and left thigh lesions and pneumonia. The methylprednisolone pulse (30 mg/kg) was initiated with the diagnosis of Sweet's syndrome. After about 10-14 days, almost all of the laboratory data regressed to nearly normal limits. After about 5 months, he was admitted again with tachypnea and high grade fever and leukocytosis. After infusion of one methylprednisolone pulse, the fever and tachypnea resolved rapidly in about 24 hours. In this admission, colchicine (1 mg/kg) was added to the oral prednisolone after discharge. In the periodic fever and neutrophilic dermatosis, the rheumatologist should search for sterile abscesses in other organs.
Sweet's syndrome is rare in children. Usually, heralded by tender polymorphous skin lesions, typically accompanied by fever and peripheral neutrophilia, can easily be mistaken for infection and lead to many antibiotic administration. Such therapy does not improve disease, which is thought to represent an immunologic reaction to agents as diverse as infection, neoplasia, or drugs. We report two boys, six and nine-year-old who suffered from acute febrile neutrophilic dermatosis. Both were febrile, had leukocytosis, and exhibited characteristic clinical and histopathologic lesions. They had an antecedent trauma, and responded to systemic corticosteroids. Our evaluation and long term follow-up of these children failed to reveal evidence of underlying malignancy or a chronic systemic illness typically encountered in Sweet's syndrome.
Sweet Syndrome secondary to infection: A case report
Bangladesh Journal of Medical Science
We present a case of a patient with Sweet Syndrome secondary to possible bacterial infection. The diagnosis of Sweet Syndrome was made based on his clinical and histopathological findings. Sweet syndrome is a rare inflammatory disorder characterised by tender erythematous skin lesions, often accompanied with fever, neutrophilia and leukocytosis. It is generally classified into classical (or idiopathic), drug-induced or malignancy-associated, each of which has its own features. Bangladesh Journal of Medical Science Vol. 21 No. 04 October’22 Page : 922-925
Sweet’s syndrome with idiopathic thrombocythemia
Advances in Dermatology and Allergology, 2014
Diagnosis of paraneoplastic skin syndromes associating neoplastic processes is assumed as the crucial aspect of dermatological practice. Knowledge of clinical findings of dermatoses suggesting coincidence of malignant proliferative processes facilitates diagnostic and therapeutic procedures. We would like to present a case of Sweet's syndrome, qualified for comparative paraneoplastic skin syndromes. Sweet's syndrome, acute, febrile neutrophilic dermatosis, was first described by Robert Douglas Sweet in 1964 as a disorder characterized by fever, skin lesions of erythematous-infiltrative character, leukocytosis with neutrophilia and dense infiltrations of dermis by mature neutrophils. Sweet's syndrome aetiology is not fully understood, although cytokine abnormalities suggest that Th1 lymphocytes play an important role in pathogenesis of the dermatosis. Factors inducing Sweet's syndrome include: haematopoietic hyperplasia; neoplasms: genitourinary, breast, gastrointestinal; infections of the respiratory and alimentary system; inflammatory bowel diseases; drugs; pregnancy and vaccinations. Systemic corticosteroids are the "gold standard" of Sweet's syndrome treatment; potassium iodide or colchicine may also be used. Indomethacin, clofazimine, cyclosporine A and sulfones are the second-line drugs.
Acute febrile neutrophilic dermatosis in childhood (Sweet's syndrome)
British Journal of Dermatology, 1991
We report a case of Sweet's syndrome in childhood. Our patient suffered from repeated fevers, chest infections and had characteristic erythematous plaques. The severity of his illness increased with age and warranted oral steroid treatment. We review lf> cases reported to date in the literature and comment on the management and prognosis of the disease in childhood.
Sweet's syndrome: A revisit for hematologists and oncologists
Critical Reviews in Oncology/Hematology, 2013
The diagnosis of Sweet's syndrome rests on a combination of clinical symptoms and characteristic physical and pathologic features. Patients typically have fever and tender erythematous skin lesions (papules, nodules, or plaques). Neutrophilia, high levels of serum inflammatory markers, and diffuse mature neutrophil infiltration localized to the upper dermis are the most important findings. Sweet's syndrome was first described by Robert Sweet in 1964, whose sentinel paper described 8 women with fever, leukocytosis, and erythematous plaques infiltrated by neutrophils. Subsequently, extracutaneous sites were included in the diagnosis. This review of publications between 1964 and April 2012 found 1683 reports of Sweet's syndrome of which only 8 were published between 1964 and 1969, after which the number of the papers grew by decades to 59, 228, 459 and 692. With more articles, there are more reports of malignancy-associated Sweet's syndrome. This may reflect the awareness by physicians of the disease and of the drugs which may cause it. There is considerable overlap in the constitutional findings of Sweet's syndrome and malignant disorders. It is crucial that the possibility of Sweet's syndrome be included in a hematologist or oncologist's differential diagnosis of fever and skin lesions.