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Sweet's Syndrome Disease

Sweet's syndrome (SS) is an uncommon, recurrent skin disease characterized by painful plaque-forming inflammatory papules and associated with fever, arthralgia, and peripheral leukocytosis.

Causes of Sweet's Disease

Sweet's is a reaction to an internal condition. It may follow:

• Upper respiratory tract infection (e.g. chest infection, streptococcal throat infection)
• Vaccination
• Pregnancy
• Inflammatory bowel disease (e.g. ulcerative colitis or Crohn's disease)

Signs and symptoms of Sweet's Disease

Prodromes are febrile upper respiratory tract infections. GI symptoms (diarrhea), tonsillitis, influenza-like illness, 1 to 3 weeks before skin lesions. Lesions tender/painful. Fever (not always present), headache, arthralgia, general malaise.

Skin lesions Bright red, smooth, tender papules (2 to 4 mm in diameter) that coalesce to form irregular, sharply bordered, inflammatory plaques. Pseudovesiculation: intense edema gives the appearance of vesiculation. Lesions arise rapidly, and as they evolve, central clearing may lead to annular or arcuate patterns. Tiny, superficial pustules may occur. If associated with leukemia, bullous lesions may occur, and lesions may mimic pyoderma gangrenosum. May present as a single lesion or multiple lesions, asymmetrically distributed. Most commonly on face and neck, upper extremities but also lower extremities where lesions may be deep in the panniculus and thus mimic panniculitis or erythema nodosum. Truncal lesions are uncommon but widespread, and generalized forms occur.

Diagnosis

Clinical impression plus skin biopsy confirmation.

Treatment of Sweet's Disease

Treatment usually results in rapid improvement in symptoms. Usually, systemic steroids (prednisone) are prescribed in a dose of 30-40 mg daily at first.

Prednisone 30 to 50 mg/d, tapering in 2 to 3 weeks; some but not all patients respond to dapsone, 100 mg/d, or to potassium iodide.

Antibiotic Therapy Clears eruption in Yersinia-associated cases; in all other cases antibiotics are ineffective.

Prevention of Sweet's Disease

It is important to follow your doctor's recommendations for treatment.