Case reports Sweet's Syndrome

Sweet’s Syndrome

Abstract

SWEET’S SYNDROME : A CASE REPORT

Introduction : Acute febrile neutrophilic dermatosis or Sweet's syndrome (SS) is characterized by painful, erythematous plaques of rapid onset accompanied by fever. The etiology of SS is unknown and it may be associated with antecedent infections, malignancies, autoimmune diseases, drugs and vaccines, upper respiratory or gastrointestinal infection, pregnancy, inflammatory bowel disease as well as chemotherapy or idiopathic.

Case report : A 35 year old female presented in dermatology OPD with red raised lesions associated with itching and burning since 10 days.

Patient also had history of allergy to milk, milk products and fish.

The lesions were associated with fever and arthralgia.

She was a known case of hypothyroidism and hypertension.

On examination : There were multiple erythematous plaques and few wheals which were blanchable on diascopy. Dermographism was positive.

Upon skin biopsy, the superficial dermis showed loss of rete ridges and perivascular infiltrate composed of neutrophils and lymphocytes. These features were consistent with Sweet’s syndrome.

On blood investigations, neutrophilia was seen.

ESR and CRP were raised.

Treatment : The acute attack was controlled with oral corticosteroids (0.5mg/kg) and later she was shifted on Colchicine 0.5mg BD to control the disease.

Dicussion : SS has no racial predilection; it is more common in females than males (3:1). Most cases are between the ages of 30 and 50 years. It’s etiology is unknown mostly but has been associated with many conditions.

When limited to the skin, SS is a benign condition which may resolve spontaneously but the most effective therapy is oral prednisone for 2-6 weeks.

Conclusion : Accurate diagnosis is necessary to treat the patient. Although, the etiology is idiopathic most commonly, sweet’s syndrome may be associated with life threathning conditions like malignancy whicb need to be diagnosed and treated accordingly.