Journal List > J Rheum Dis > v.20(3) > 1064042

Seo, Lee, Ji, Song, Yoo, Ahn, and Choi: A Case of Sweet's Syndrome Associated with Rheumatoid Arthritis Involving Multiple Skin Lesions

Abstract

Sweet's syndrome is a neutrophilic dermatoses characterized by the abrupt onset of fever, leukocytosis and skin lesions that are infiltrated by neutrophils. Most skin lesions are in the form of erythematous tender papules or nodules, usually affecting the upper limbs, face or neck and histologically a dense perivascular infiltrate of neutrophils without vasculitis. Sweet's syndrome can be associated with several disorders, such as inflammatory bowel disease, malignant tumors, and autoimmune diseases including rheumatoid arthritis. We report a case of Sweet's syndrome with associated rheumatoid arthritis. The patient had multiple skin lesions in her face, neck, both upper and lower extremities except trunk, and complained fever, chills and arthralgia. The result of skin biopsy showed mature neutriphil infiltration and leukocytoclasia of dermis without vasculitis, which was compatible with Sweet's syndrome.

References

1. Sweet RD. An acute febrile neutrophilic dermatosis. Br J Dermatol. 1964; 76:349–56.
2. Cohen PR, Almeida L, Kurzrock R. Acute febrile neutrophilic dermatosis. Am Fam Physician. 1989; 39:199–204.
3. Choi JH, Sung KJ, Ahn SJ, Jang KA, Moon KC, Koh JK. Clinical study of 24 cases with sweet's syndrome. Korean J Dermatol. 2000; 38:163–9.
4. Park YT, Jeong YS, Park TH, Yoo JH, Kim KJ. A case of sweet's syndrome associated with rheumatoid arthritis. Korean J Dermatol. 2003; 41:1686–8.
5. Su WP, Liu HN. Diagnostic criteria for Sweet's syndrome. Cutis. 1986; 37:167–74.
6. Petrozzi JW, Warthan TL. Sweet's syndrome: unique local response to streptococcal antigen. Cutis. 1976; 17:267–72.
7. von den Driesch P. Sweet's syndrome (acute febrile neutrophilic dermatosis) J Am Acad Dermatol. 1994; 31:535–56.
8. Chan HL, Lee YS, Kuo TT. Sweet's syndrome: clinicopathologic study of eleven cases. Int J Dermatol. 1994; 33:425–32.
crossref
9. Harary AM. Sweet's syndrome associated with rheumatoid arthritis. Arch Intern Med. 1983; 143:1993–5.
crossref
10. Sitjas D, Puig L, Cuatrecasas M, De Moragas JM. Acute febrile neutrophilic dermatosis (Sweet's syndrome). Int J Dermatol. 1993; 32:261–8.
crossref
11. Delaporte E, Gaveau DJ, Piette FA, Bergoënd HA. Acute febrile neutrophilic dermatosis (Sweet's syndrome). Association with rheumatoid vasculitis. Arch Dermatol. 1989; 125:1101–4.
crossref
12. Cohen PR, Kurzrock R. Sweet's syndrome: a review of current treatment options. Am J Clin Dermatol. 2002; 3:117–31.

Figure 1.
(A-C) Erythematous tender papule and nodule over face, neck, and both upper and lower extremities. (D) Improved joint lesions after steroid therapy.
jrd-20-190f1.tif
Figure 2.
(A) A diffuse infiltrate of neutrophils with leukocytoclasia in dermis (H&E, ×40), (B) An infiltration of predominantly neutrophils, yet no evidence of vasculitis (H&E, ×200).
jrd-20-190f2.tif
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