DR MOHAMMED IRFAN SHEIKH about 5 years ago

Sweet’s Syndrome

A 54-year-old man who had previously undergone a proctocolectomy for ulcerative colitis presented with a 3-day history of fever and abdominal pain. He was found to have an intraabdominal abscess and was admitted to the hospital. His condition was improving with treatment, which included intravenous antibiotic agents and drainage of the abscess. On day 7 of his hospital stay, his temperature was 38.5°C, and painful skin lesions developed; the lesions started as pustules and evolved over 48 hours to form plaques with a transparent, vesicle-like appearance on the back and side of his neck. Similar lesions were noted on the patient’s midline laparotomy scar and on his ears. Laboratory studies on day 7 showed a white-cell count of 18×109 per liter (reference range, 4×109 to 10×109), 80% neutrophils, and an erythrocyte sedimentation rate of 40 mm per hour (reference range, 0 to 22). Biopsy of one of the lesions showed inflammatory infiltrates of neutrophils and edema in the upper dermis. A diagnosis of the inflammatory disorder Sweet’s syndrome (also called acute febrile neutrophilic dermatosis) was made. Treatment with oral prednisone was initiated. The patient’s fever resolved within 1 day after treatment began, and the lesions resolved completely within 5 days.