Sweet syndrome (acute febrile neutrophilic dermatosis) is a relatively rare inflammatory di-sease, which is characterized by the sudden appearance of tender erythematous skin lesions, often accompanied by pyrexia and elevated neutrophil count. The pathogenesis is not clear yet. Recently, multiple studies have found the association between Sweet syndrome and infections, autoimmune diseases, malignant tumors and the application of multiple drugs. According to different causes, Sweet syndrome can be divided into three types: classical (or idiopathic) Sweet syndrome, malignancy-associated Sweet syndrome and drug-induced Sweet syndrome. Classical Sweet syndrome usually presents in women between the age of 30 to 50 years and may be related to infection, inflammatory bowel disease, or pregnancy. The clinical symptoms typically respond promptly after corticosteroid therapy. The major diagnostic criteria of classical Sweet syndrome include sudden painful erythematous skin lesions, histopathologic evidence of a dense neutrophilic infiltrate without evidence of leukocytoclastic vasculitis; minor criteria include pyrexia over 38 ℃, association with hematologic or visceral malignancies, inflammatory diseases, pregnancy or preceded by infection, prompt response to systemic glucocorticoid or potassium iodide treatment, abnormal laboratory values (three of four: erythrocyte sedimentation rate >20 mm/h, positive C-reactive protein, >8.0×10⁹/L leukocytes, >70% neutrophils). The presence of both major criteria and two of the four minor criteria are required to diagnose classical Sweet syndrome. As for the malignancy-associated Sweet syndrome, skin lesions can be found precede, follow, or at the same time with the diagnosis of hematologic malignancy or a solid tumor. At present, ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) is commonly used as a positron emission tomography computed tomography (PET/CT) imaging agent for diagnosing and screening malignant tumors. Therefore, most of the case reports on the ¹⁸F-FDG PET/CT manifestations of Sweet syndrome are malignancy-associated. Even classical Sweet syndrome is often accompanied by inflammatory bowel disease, autoimmune diseases, etc. Therefore, for patients with suspected or confirmed Sweet syndrome, it is necessary to take ¹⁸F-FDG PET/CT examination to clarify the general condition, whether it is for patients with malignant signs such as elevated tumor markers values and weight loss, or for patients with classical Sweet syndrome to exclude underlying inflammatory diseases. ¹⁸F-FDG PET/CT is often able to detect the solid tumor early, and assess the degree of hematologic malignancy and inflammatory disease. This study reported a classical Sweet syndrome case associated with inflammatory bowel disease, which was confirmed with skin and intestinal histological examination. The clinical manifestations, laboratory values, ¹⁸F-FDG PET/CT manifestations of the patient related diseases were reported, which was to improve nuclear medicine physicians' understanding of Sweet syndrome. Early diagnosis and treatment can often achieve excellent clinical effect.
Humans ; Sweet Syndrome/diagnostic imaging* ; Fluorodeoxyglucose F18 ; Positron Emission Tomography Computed Tomography ; Female

Neutrophilic dermatosis of the hands (NDH) is an uncommon inflammatory condition recognized as a localized variant of Sweet syndrome, seen in older adults with malignancy or systemic inflammatory disease. We present a rare case of NDH in a 23-year-old male in an unusual location, without the typical associated systemic illness or recent trauma. The patient presented with recurrent, painful erythematous nodules exclusively on the fingers and a violaceous bulla-like plaque on the volar surface of the left index finger. Laboratory tests showed leukocytosis with neutrophilia, elevated erythrocyte sedimentation rate, and normal C-reactive protein levels. Investigations for other underlying causes were unremarkable. Histopathologic examination was consistent with NDH. He was treated with dapsone 50 mg daily, with resolution in 3 weeks, and no recurrence was reported. This case expands the clinical spectrum of NDH. It highlights the importance of considering it in the differential diagnosis of painful hand lesions in younger patients, even in the absence of typical risk factors or systemic involvement.

Sweet syndrome, or acute febrile neutrophilic dermatosis, is a rare inflammatory condition characterized by painful erythematous plaques, fever, and neutrophilia. While it is often associated with malignancy or drug reactions, it may also occur following streptococcal infection. This case highlights the importance of early recognition and treatment of Sweet syndrome secondary to streptococcal pharyngitis.

A 44-year-old female presented with painful erythematous papules and nodules on her extremities, neck, and nape, associated with fever and chills. The lesions started as skin-colored papules that rapidly progressed to painful erythematous plaques. Her medical history included a sore throat two weeks prior. Initial management Clindamycin provided temporary relief, but the lesions persisted. Laboratory work revealed neutrophilic leukocytosis, elevated erythrocyte sedimentation rate (ESR), and an elevated anti-streptolysin O titer. A skin biopsy showed diffuse neutrophilic dermatitis with vasculitis, confirming the diagnosis of Sweet syndrome. Subsequent treatment with oral corticosteroids led to significant clinical improvement over a week.

This case illustrates the importance of considering infectious triggers, such as streptococcal infections, in the diagnosis of Sweet syndrome. Early diagnosis and appropriate treatment with corticosteroids are essential in preventing complications. Reporting this case contributes to the understanding of non-malignant triggers of Sweet syndrome and underscores the need for heightened awareness of this rare condition in patients presenting with acute febrile dermatosis.

Sweet syndrome (SS), or acute febrile neutrophilic dermatosis, is a rare inflammatory disorder characterized by fever, painful raised plaques, and dermal neutrophilic infiltration. Pediatric cases account for only 5% of SS globally, and no report exists of SS in infants in the Philippines. This report documents a unique case of SS in a one-month-old male, one of the first documented in the country. The rarity of this condition in infants and its successful management contribute valuable insights into the understanding and treatment of pediatric SS.

A one-month-old male presented with fever, erythematous plaques on the face and extremities, and a rapidly growing nodule on the left lateral neck, along with concurrent fever and cough. Skin biopsy showed dermal neutrophilic infiltration without leukocytoclastic vasculitis, confirming SS. A CT scan revealed a neck abscess and pneumonia. The abscess was treated with incision and drainage, and IV antibiotics. Due to the infection, systemic corticosteroids were contraindicated. Instead, topical hydrocortisone was applied, leading to rapid improvement of the skin lesions. This highlights a successful approach for managing SS when systemic therapy is unsuitable.

This case emphasizes the importance of early diagnosis and individualized treatment in rare pediatric cases of Sweet syndrome. The effective use of topical hydrocortisone in place of systemic steroids demonstrates the potential of alternative therapies, especially when infections preclude standard treatments. This case, one of the first in a neonate in the Philippines, contributes valuable insights to the limited literature on managing this rare condition in infancy.

No abstract available.
Humans ; Leukemia ; Leukemia, Myeloid, Acute ; Sweet Syndrome

Sweet's syndrome also known as acute neutrophilic dermatosis is a multisystem inflammatory disorder characterized by fever, malaise, leukocytosis, and skin lesions. Sweet's syndrome affects multiple organs though only rarely does it affect the central nervous system (CNS) when it does it is called Neuro-Sweet disease (NSD). We report on a case study of a biopsy-proven NSD in a 50 year old man. Serial magnetic resonance imaging (MRI) showed repeated CNS involvement of Sweet's syndrome after a respiratory tract infection preceded it. On the MRI, T2 hyperintense lesions occurred at multiple sites and disappeared after steroid therapy.
Central Nervous System ; Fever ; Leukocytosis ; Magnetic Resonance Imaging ; Neutrophils ; Respiratory Tract Infections ; Skin ; Skin Diseases ; Sweet Syndrome

No abstract available.
Blindness* ; Sweet Syndrome*

Neutrophilic myositis is a very rare disease histologically characterized by neutrophil infiltration of muscle tissues. We report a case of a 47-year-old man who presented with acute onset of severe swelling and pain on his left shoulder with high fever. He was initially suspected of having cellulitis, but intravenous antibiotics did not improve his symptoms. Similar swelling and pain then developed on both calves. Investigations with magnetic resonance imaging of the lower legs and muscle biopsy led to a diagnosis of neutrophilic myositis. High dose glucocorticoid dramatically improved his symptoms within days. Clinicians need to be aware of this rare disease as a cause of acute febrile myositis mimicking infection.
Anti-Bacterial Agents ; Biopsy ; Cellulitis ; Diagnosis ; Fever ; Humans ; Leg ; Magnetic Resonance Imaging ; Middle Aged ; Myositis* ; Neutrophil Infiltration ; Neutrophils* ; Rare Diseases ; Shoulder ; Sweet Syndrome

Sweet syndrome (acute, febrile, neutrophilic dermatosis) is characterized by the acute onset of an eruption of painful nodules or erythematous or violaceous plaques on the limbs, face and neck. These symptoms are accompanied by fever. The diagnostic features include histopathological findings of dermal neutrophilic infiltration without leukocytoclastic vasculitis or peripheral blood leukocytosis. Sweet syndrome is associated with infection, malignancies, autoimmune disease, pregnancy, and drugs. Patients with Sweet syndrome demonstrate a complete and rapid response to systemic steroid administration. Recently, a distinct variant of Sweet syndrome was reported, termed “histiocytoid Sweet syndrome”, in which the infiltration of myeloperoxidase-positive histiocytoid mononuclear cells are observed (in contrast to the infiltration of neutrophils). The other clinical features are similar to those of classic Sweet syndrome. Pediatric Sweet syndrome is uncommon, and the histiocytoid type is even rarer. To date, four cases of histiocytoid Sweet syndrome have been reported in children. Herein, we describe a case of histiocytoid Sweet syndrome in an otherwise healthy 10-year-old boy with no underlying systemic disease in whom non-steroidal, anti-inflammatory drug treatment was successful.
Autoimmune Diseases ; Child* ; Extremities ; Fever ; Humans ; Leukocytosis ; Male ; Neck ; Neutrophils ; Peroxidase ; Pregnancy ; Sweet Syndrome* ; Vasculitis

Neutrophilic dermatoses comprise a wide spectrum of inflammatory diseases with overlapping features characterized histologically by the presence of an aseptic neutrophilic infiltrate in the epidermis, dermis, and/or hypodermis and are often associated with systemic inflammatory and neoplastic disorders. Here we report a case of a 75-year-old man who developed painful indurated plaques with a vesicular, bullous, and even hemorrhagic appearance similar to cellulitis on his right leg along with a fever that raised his body temperature up to 39℃ and malaise.
Aged ; Body Temperature ; Cellulitis ; Dermis ; Epidermis ; Fever ; Humans ; Leg ; Neutrophils ; Skin Diseases ; Subcutaneous Tissue ; Sweet Syndrome* ; Waldenstrom Macroglobulinemia*