Sweet’s Syndrome

David Deneau MD

Acute Neutrophilic Dermatosis

(Sweet RD. Br. J. Dermatol.1964; 76:349-56)

Sweet’s Syndrome

Sweet’s Syndrome

Sweet’s Syndrome

Sweet’s Syndrome

Sweet’s Syndrome

Sweet’s Syndrome

Sweet’s Syndrome

Sweet’s SyndromeClinical Features

• Tender to painful red plaques face, hands, arms, upper trunk

• Acute onset• Frequently associated with;

PMN leucocytosis

Fever

Arthralgias

Malaise

Sweet’s Syndrome

Histology• Diffuse neutrophilic infiltrate in upper dermis • Leucocytoclasis• Without evidence of primary leucocytoclastic

vasculitis

Sweet’s Syndrome

Associated Disorders

50% cases are idiopathic

50% may be associated with underlying disease

• Malignancy (20 – 25%)

Leukemia

Lymphoma

Carcinomas

Sweet’s Syndrome

Associated Disorders, (continued)

• Infection: Streptococcal URIYersinial GI infection

• Pregnancy

• Inflammatory Bowel Disease

Sweet’s Syndrome

Associated Disorders (continued)

• Drug Reactions: G-CSF

Minocycline

Trimethoprim – Sulfamethoxazole

all – trans Retinoic Acid

Oral Contraceptives

Sweet’s Syndrome

Sweet’s Syndrome

Sweet’s Syndrome

Sweet’s Syndrome

Sweet’s Syndrome

Sweet’s Syndrome

Sweet’s Syndrome

Sweet’s Syndrome

Treatment

• Systemic corticosteroidsUsually dramatic response4-6 week tapering courseRelapse may occur

• ColchicineMay be effective in mild disease

Sweet’s Syndrome

Treatment (continued)

• Potassium iodide• Indomethacin• Dapsone• Cyclosporine• Tetracycline type antibiotics