Sweet syndrome

What is Sweet Syndrome?

Sweet syndrome, also known as acute febrile neutrophilic dermatosis, is a rare inflammatory skin condition characterized by the sudden onset of fever and painful rash on various parts of the body.

Symptoms of Sweet Syndrome:

• Sudden onset of fever
• Painful rash on arms, legs, trunk, face, or neck
• Tender red or bluish-red lesions that can coalesce to form larger patches
• Raised red skin rashes
• Neutrophils (pus cells) infiltrating the upper layer of the skin

Characteristics of Sweet Syndrome:

• A reactive process characterized by the abrupt onset of tender, red-to-purple papules and nodules
• Can be triggered by various factors such as infections, medications, or underlying medical conditions
• Typically presents with fever, raised red skin rashes, and neutrophils infiltrating the upper layer of the skin

References:

• [1] Sweet syndrome is a rare inflammatory skin condition characterized by a sudden onset of fever and painful rash on the arms, legs, trunk, face, or neck.
• [2] Oct 15, 2015 — Sweet syndrome is a rare disorder characterized by fever and the sudden onset of a rash, which consists of multiple tender, red or bluish-red ...
• [3] May 20, 2024 — Sweet syndrome is a rare autoinflammatory skin disorder characterized by a fever and sudden outbreak of a rash with multiple lesions.
• [4] Sweet's syndrome usually presents with fever, a rise in white blood cells, raised red skin rashes and neutrophils (pus cells) infiltrating the upper layer of ...
• [5] Jun 2, 2020 — This condition is a reactive process characterized by the abrupt onset of tender, red-to-purple papules and nodules that coalesce to form ...
• [6] Sweet syndrome, also called acute febrile neutrophilic dermatosis, is a rare skin disorder. It is characterised by fever and the appearance of tender red or ...
• [7] Feb 17, 2023 — Sweet syndrome is characterized by an outbreak of small red bumps on your body.
• [8] Acute febrile neutrophilic dermatosis is an uncommon skin condition characterised by fever, inflamed or blistered skin, and mucosal lesions.

Sweet syndrome, also known as acute febrile neutrophilic dermatosis, is characterized by a sudden onset of fever and the appearance of tender red or purple lumps or patches on the skin that may turn into ulcers [1]. The primary symptom of Sweet syndrome is the rapid onset of tender or painful bumps or lesions on the skin [5].

The symptoms of Sweet syndrome can vary from person to person, but common signs include:

• Fever
• Sudden onset of a rash, which consists of multiple tender, red or bluish-red papules, plaques, and nodules on the skin [1]
• Tender or painful bumps or lesions on the skin that may turn into ulcers [3]
• Skin rashes, discoloration, or abnormal pigmentation of the skin [8]

In some cases, Sweet syndrome can also involve internal organ involvement, such as fever, leukocytosis (an increase in white blood cells), and inflammation of other organs [7].

It's essential to note that Sweet syndrome is not contagious and is a rare inflammatory condition [4]. If you suspect you or someone else has Sweet syndrome, it's crucial to seek medical attention promptly.

References: [1] Oct 15, 2015 — Sweet syndrome is a rare disorder characterized by fever and the sudden onset of a rash, which consists of multiple tender, red or bluish-red ... [3] It is characterised by fever and the appearance of tender red or purple lumps or patches on the skin that may turn into ulcers. It is not contagious, not ... [4] Oct 31, 2022 — Sweet syndrome is a rare inflammatory condition. It involves a sudden onset of fever and painful skin rashes. Sweet syndrome, or acute ... [5] Feb 17, 2023 — The primary symptom of Sweet syndrome is the rapid onset of tender or painful bumps or lesions on the skin. While these lesions can appear ... [7] by JF Merola · Cited by 3 — Fever, leukocytosis, and internal organ involvement can also occur. Sweet syndrome has been associated with infection, malignancy, pregnancy, ... [8] Result: skin rashes | discoloration or abnormal pigmentation of skin | skin lesions | itchy skin | acne or pimples

Sweet syndrome, also known as acute febrile neutrophilic dermatosis, can be diagnosed through a combination of clinical assessment and laboratory tests.

Clinical Assessment

The diagnosis of classic Sweet syndrome is based on the presence of an abrupt onset of tender or painful bumps or lesions on the skin, accompanied by fever and leukocytosis (high white blood cell count) [7]. A dermatologist's examination can confirm the presence of these symptoms.

Laboratory Tests

Blood tests are also used to support the diagnosis of Sweet syndrome. These include:

• High levels of neutrophils in the blood, which indicates an increased number of white blood cells [4].
• Elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), which indicate inflammation in the body [6].

Skin Biopsy

A skin biopsy is a useful procedure to confirm a clinically suspected diagnosis of Sweet syndrome [5]. The biopsy shows neutrophils, some breaking down, entering the upper layer of the skin.

Diagnostic Criteria

The major diagnostic criteria for classic Sweet syndrome include:

• Abrupt onset of tender or painful bumps or lesions on the skin
• Fever
• Leukocytosis (high white blood cell count)
• Elevated ESR and CRP

Minor criteria include:

• High levels of neutrophils in the blood
• Abnormalities in laboratory tests, such as elevated liver enzymes [3].

A diagnosis of Sweet syndrome is made when both major and minor criteria are met.

References: [1] Jun 2, 2020 — Skin biopsy should be performed to confirm the diagnosis of Sweet syndrome (acute febrile neutrophilic dermatosis) per the major criteria listed ... [2] A skin biopsy performed by a dermatologist usually confirms the diagnosis. This shows neutrophils, some breaking down, entering the upper layer of the skin, ... [3] Sweet syndrome (SS) is a diagnosis of exclusion and is based on criteria (both of the major and 2 minor criteria are required for diagnosis). Major criteria ... [4] Blood tests such as high levels of a type of white blood cells called neutrophils, can help to make a diagnosis of Sweet syndrome. Your doctor may recommend ... [5] by PR Cohen · 2007 · Cited by 1036 — A lesional skin biopsy for routine histopathologic evaluation is a useful procedure to confirm a clinically suspected diagnosis of Sweet's ... [6] Abnormalities in laboratory tests (three of four): erythrocyte sedimentation rate> 20mm/h; high C-reactive protein, leukocytes >8000, with >70% neutrophils. [7] Feb 17, 2023 — The major diagnositic criteria for classic Sweet syndrome includes an abrupt onset of tender or painful bumps or lesions on the skin, plus ...

Treatment Options for Sweet Syndrome

Sweet syndrome, also known as acute febrile neutrophilic dermatosis, is a rare skin condition characterized by fever, rash, and inflammation. The treatment for Sweet syndrome typically involves medications to reduce inflammation and manage symptoms.

Corticosteroids: A First-Line Treatment

Systemic corticosteroids are the first-line treatment for Sweet syndrome, and they usually result in dramatic clinical improvement [6]. Corticosteroid pills can help with redness, itching, swelling, and allergic reactions [8]. Steroid creams or gels may also be used to treat localized cases of Sweet syndrome [5].

Other Medications

In addition to corticosteroids, other medications have been effective in managing Sweet syndrome. These include:

• Indomethacin, clofazimine, dapsone, and cyclosporine, which have been shown to be effective therapeutic agents for managing Sweet's syndrome [2]
• Doxycycline, metronidazole, isotretinoin, methotrexate, cyclophosphamide, chlorambucil, adalimumab, infliximab, and intravenous immunoglobulin (IVIG), which have been used in various cases of Sweet syndrome [3]

Topical Treatments

In mild localized cases, corticosteroids can be applied as a cream or injected into areas of Sweet's syndrome [5]. Topical antifungals, steroids, antibiotics, and miscellaneous topical agents may also be used to treat Sweet syndrome, although their effectiveness varies depending on the individual case [10].

References

[1] Treatment for Sweet syndrome involves corticosteroid medications, such as prednisone, which are used to reduce inflammation. In most cases, medications reduce symptoms.

[2] Indomethacin, clofazimine, dapsone, and cyclosporine have also been effective therapeutic agents for managing Sweet's syndrome.

[3] Doxycycline, metronidazole, isotretinoin, methotrexate, cyclophosphamide, chlorambucil, adalimumab, infliximab, intravenous immunoglobulin (IVIG) have been used in various cases of Sweet syndrome.

[4] Sweet syndrome is treated with corticosteroids. Introduction. Sweet syndrome was first described in the medical literature in 1964 by Dr. Robert.

[5] Corticosteroids can be applied as a cream or injected into areas of Sweet's syndrome in mild localised cases. Alternative treatments may be used in cases where...

[6] Systemic glucocorticoid therapy is a first-line treatment for Sweet syndrome, and usually results in dramatic clinical improvement.

[7] Jun 2, 2020 — The best-documented first-line options are systemic corticosteroids or topical steroids if the lesions are limited. If the use of...

[8] May 20, 2024 — Corticosteroid pills can help with redness, itching, swelling, and allergic reactions. Steroid creams or gels also may help -- especially with...

[9] by S Jeanfils · 1997 · Cited by 84 — Background: The standard treatment for Sweet's syndrome (acute febrile neutrophilic dermatosis) is oral corticosteroids. Despite a good initial response, ...

[10] Result: | male | female | all topical antifungals | 15% | 39% | 27% topical steroids | 37% | 9.5% | 23% topical antibiotics | 41% | 0% | 21% miscellaneous topical agents | 31% | 3.8% | 18% azole antifungals | 23% | 7.3% | 15% (up to 8 drugs prescribed or renewed during a health care provider visit; data may not include preexisting drug regimens; estimates based on NAMCS and NHAMCS, 2006 to 2007)

Differential Diagnosis of Sweet Syndrome

Sweet syndrome, also known as acute febrile neutrophilic dermatosis (AFND), is a rare skin condition characterized by the sudden onset of fever, leukocytosis, and tender erythematous skin lesions. The differential diagnosis of Sweet syndrome includes various conditions that may present with similar clinical features.

Infections

• Bacterial infections: Cellulitis, abscesses, and other bacterial infections can mimic the symptoms of Sweet syndrome.
• Fungal infections: Fungal infections such as candidiasis or dermatophytosis can also be considered in the differential diagnosis.
• Mycobacterial infections: Mycobacterial infections like tuberculosis or leprosy can present with similar skin lesions.

Inflammatory Disorders

• Vasculitis: Vasculitis, including conditions like polyarteritis nodosa or giant cell arteritis, can cause similar skin manifestations.
• Erythema multiforme: This condition is characterized by target-like lesions on the skin and can be confused with Sweet syndrome.
• Pityriasis rubra pilaris: This rare skin disorder can present with erythematous plaques and papules.

Neoplastic Conditions

• Leukemia or lymphoma: Blood-related disorders like leukemia or lymphoma can cause similar skin manifestations.
• Solid organ tumors: Tumors in the bowel, breast, or kidney can also be considered in the differential diagnosis.

Other Conditions

• Dermatologic conditions: Other dermatologic conditions such as psoriasis, eczema, or lupus erythematosus can present with similar symptoms.
• Systemic diseases: Systemic diseases like sarcoidosis or granulomatosis with polyangiitis can also be considered in the differential diagnosis.

Key Points to Consider

• The presence of fever, leukocytosis, and tender erythematous skin lesions is a key feature of Sweet syndrome.
• A dense neutrophilic infiltrate on biopsy is characteristic of Sweet syndrome.
• The clinical features of Sweet syndrome can be similar to those of other conditions, making differential diagnosis essential.

References

• [8] Bacterial, fungal, and mycobacterial infections all merit consideration in the differential diagnosis of Sweet syndrome.
• [10] Cutaneous conditions and systemic diseases, as well as infectious and inflammatory disorders, neoplastic conditions, reactive erythemas, and vasculitis should be considered in the clinical differential diagnosis.
• [13] The pathophysiology, clinical presentation, diagnostic work, differential diagnosis, and management of malignancy-associated Sweet's syndrome have been reported in various cases.