Sweet's syndrome. Cohen PR, 2007. CC BY 2.0
Sweets disease, Sweets syndrome (Acute neutrophil dermatosis) L 98.2
Contents
Definition
Sweets syndrome is an inflammatory disease with sudden onset and fever attack, where skin, eyes, muscles, joints and organs can be attacked. Described in 1964 by RD Sweet
Symptoms
The rash occurs suddenly and consists of tender knots (papules) or hard spots (plaque) that go into depth
- Fever
- Joint and headache
- Sore eyes and mouth ulcer
- Can attack most internal organs
Occurrence
Sweets syndrome is rare, but most common among middle-aged women. It is also described in men and children of all ages
Disposing conditions
- Respiratory infection
- Vaccination
- IBD (Ulcerative colitis or Crohn's disease)
- Rheumatoid arthritis
- Blood diseases, including Leukemia
- Most often acute myelogenous leukemia
- Cancer disease most often in the gut, urogenital tract (urinary tract) or breast / mother
- Pregnancy
Sweet's syndrome. Cohen PR, 2007. CC BY 2.0
Medical Examination
- Erythrocyte sedimentation rate (ESR) and CRP are elevated (systemic inflammation)
- Increased white blood cell count (neutrophil leukocytosis)
- Skin biopsy: shows in depth many neutrophilic granulocytes which are a type of white blood cell (neutrophil dermatosis) and destroyed cells (leukocytoclastic), as well as edematous endothelial cells in blood vessel walls (vasculitis)
Course of disease
One or more red and tender lumps in or under the skin that increase in size and last for several weeks. Skin changes may also have blisters (pustules), ulcers (ulcerations) and may fade in the center. Can sometimes look like pyoderma gangrenosum
Incorrect diagnosis (similar illnesses / differential diagnoses)
- Behcet's disease
- Dermatomyositis
- DRESS syndrome and other skin reactions to medications
- Infection / sepsis / erysipelas
- Endocarditis (infection)
- Herpes zoster
- Leukocytoclastic vasculitis
- Leukemia cutis
- Lymphoma
- Mycobacterium marinum (Skin, joints, fever)
- PAN (Polyarteritis nodosum)
- Panniculitis
- Pyoderma gangrenosum
- Roseacea
- Serum sickness / hypersensitivity syndrome
- Fungal infection, Systemic mycosis
- Systemic lupus (SLE)
- Tuberculosis (Tbc)
Treatment
Steroids (Prednisone) will be used first. If not enough effect is used Dapson, Colchicine or biological immunosuppressive drugs. NSAIDs can relieve symptoms.
