Sweets syndrome (aka acute febrile neutrophilic dermatosis)

Question 1

M:F for Sweets syndrome:

Answer 1

F:M = 3:1

Question 2

What are the 5 major subtypes of Sweets syndrome?

Answer 2

1. Classic (60-70%)
2. cancer-associated (10-20%)
3. Inflammatory disease-released (10-15%)
4. drug induced (5%)
5. Pregnancy (2%)

Question 3

Pathogenesis of Sweets syndrome?

Answer 3

Unknown

Question 4

Clinical presentation of Sweets syndrome:

Answer 4

• rapid onset of tender/burning red, well-demarcated, expanding, Juicy/edematous papule and plaques favoring head/neck/upper extremities
• may become vesiculobullous or pustular, may have targetoid appearance

Question 5

What are the extracutaneous features of Sweets syndrome?

Answer 5

• fever (50-80%)
• malaise/preceeding URI or flu symptoms
• arthralgias
• ocular involvement (conjunctivitis, episcleritis, iridioyclitis)

Question 6

Lab abnormalities in Sweets syndrome:

Answer 6

Leukocytosis (70%) w/ neutrophilia

ESR/CRP elevated

Question 7

What are the triggers of Sweets?

Answer 7

Sweet As Dr. Peppers Insides

Infections:Strep

Cancer: AML

Drugs: G-CSF, minocycline, OCPs, Bactrim

Other: Pregnancy, autoimmune CTD’s, HIV, Hep C

-IBD

Question 8

Histopath of Sweets syndrome:

Answer 8

Diffuse dermal neutrophilic infiltrate + massive Papillary dermal edema

Question 9

Treatment of Sweets syndrome?

Answer 9

Systemic steroids (0.5mg/kg - 1.0mg/kg daily) for 4-6 weeks

• this works fast and patients respond well

Question 10

Clinical course of Sweets syndrome?

Answer 10

resolves within 2-3 months without scarring (vs PG which leaves cribriform scars)