Sweet Syndrome

Sweet syndrome, first described in 1964 by Robert Douglas Sweet, is an acute febrile neutrophilic dermatosis. Neutrophilic dermatoses consist of a group of non-infectious disorders that are characterized by neutrophilic infiltration of the skin (epidermis, dermis or hypodermis) with or without true vasculitis. Neutrophilic dermatoses can be idiopathic or secondary to an underlying disorder, localized or generalized and may or may not have extracutaneous manifestations. Sweet syndrome belongs to the non-vasculitic group of neutrophilic dermatoses disorders, with others including pyoderma gangrenosum, pustular psoriasis, reactive arthritis (Keratoderma blennorrhagicum), Bowed-associated dermatosis-arthritis syndrome (BADAS), rheumatoid neutrophilic dermatosis, Behcet's disease, acne fulminans, Familial Mediterranean Fever, SAPHO syndrome, etc. Sweet syndrome is characterized by sudden onset of well defined tender plaques or nodules accompanied by fever, arthralgias, ocular inflammation, headaches and, rarely, oral or genital lesions. It may also be associated with other extracutaneous systemic manifestations which are however rare. The goal of pharmacotherapy in acute febrile neutrophilic dermatosis (Sweet Syndrome) is to reduce morbidity and complications. The best first-line option is systemic or topical corticosteroids if the lesions are limited. If corticosteroids are contraindicated, anti-inflammatory medications such as colchicine or dapsone can be used.