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Sweet’s Syndrome

What is Sweet’s syndrome?

Highlights

  1. An outbreak of small red bumps on the arms, neck, back, or face can signal that you have the rare disease called Sweet’s syndrome.
  2. Triggers may include an infection, an illness, and certain medications.
  3. Medication may help treat an episode of Sweet’s syndrome, but the condition is likely to recur.

Sweet’s syndrome is also called acute febrile neutrophilic dermatosis. It was originally described by Dr. Robert Douglas Sweet in 1964.

There are three clinical types of Sweet’s syndrome:

  • classic or idiopathic (no identified cause)
  • malignancy-associated (related to cancer)
  • drug-induced (triggered by a drug)

Its primary symptoms are a fever and a rapid onset of skin lesions that are painful, swollen red bumps. The lesions appear most commonly on the neck, arms, back, or face. But they may appear anywhere on the body.

Generally, people with Sweet’s syndrome feel very ill and may have other symptoms, including pain in the joints, headaches, muscle aches, or fatigue.

This condition is rare and may not be quickly diagnosed. Your doctor may send you to a dermatologist for diagnosis and treatment. People with Sweet’s syndrome are often given corticosteroid pills, such as prednisone. With treatment, symptoms typically go away after a few days, though recurrence is common.

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Symptoms

What are the symptoms?

An outbreak of painful, swollen red lesions on the arms, neck, back, or face can signal that you have Sweet’s syndrome. The bumps can grow in size quickly, and they show up in clusters that can grow to about an inch in diameter.

The lesions may be just one or several connecting to each other. They often have a clear blister and sometimes have an annular or target-like appearance. Most lesions will heal without scarring. However, some lesions may also recur in one-third to two-thirds of people with this condition.

Other areas of the body can be affected by Sweet’s syndrome, including:

  • bones
  • central nervous system
  • ears
  • eyes
  • kidneys
  • intestines
  • liver
  • heart
  • lung
  • mouth
  • muscles
  • spleen

If you experience a sudden rash that spreads, you should contact your doctor as soon as possible.

Causes

What causes Sweet’s syndrome?

Sweet’s Syndrome is considered an autoinflammatory disease. This means that the body’s immune system causes the condition. Often an underlying systemic disease such as an infection, inflammation, or other illness triggers the condition.

Vaccinations or certain medications can also potentially trigger this condition. Azacitidine, a standard treatment of myelodysplastic syndrome, is known to increase the chance of getting Sweet’s syndrome. People with Crohn’s disease or ulcerative colitis may also have a higher risk. It can also appear in some cancer patients, specifically those with:

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Risk Factors

Who is at risk?

Sweet’s syndrome is not a common condition. It occurs worldwide in all races, but a few factors may increase your risk:

  • being a woman
  • being between the ages of 30 and 50
  • having leukemia
  • being pregnant
  • having recently recovered from an upper respiratory infection
  • having Crohn’s disease or ulcerative colitis

Diagnosis

How is it diagnosed?

In most cases, a dermatologist can diagnose Sweet’s syndrome simply by looking at the lesions on your skin and reviewing your medical history. Most likely, a blood test or biopsy will be done to rule out other conditions with similar symptoms.

If organs other than skin are suspected to be involved, your doctor or dermatologist may order specialized tests.

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Treatment

How is it treated?

In some cases, the condition resolves itself. Corticosteroid pills, such as prednisone, are the most popular treatment for Sweet’s syndrome. Corticosteroids are also available as topical creams and injections.

If steroids don’t work, other immunosuppressant drugs such as cyclosporine, dapsone, or indomethacin may be prescribed. A new treatment option is a drug known as anakinra. It suppresses inflammation and is commonly used for treating rheumatoid arthritis.

If you have wounds on your skin, you’ll need proper care and treatment to prevent infection. If you have an underlying condition such as Crohn’s disease or cancer, treatment will help resolve the symptoms of Sweet’s syndrome.

With treatment, symptoms improve in about six weeks, but it’s possible that the condition may recur after treatment. Your doctor will determine which form of medication and treatment is right for you.

Home care

People with Sweet’s syndrome should be gentle on their skin. They should apply sunscreen as needed and wear protective clothing before going out in the sun.

Follow any skin care regimen or medication schedule prescribed by your doctor.

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Prevention

Preventing Sweet’s syndrome

Protecting your skin from prolonged sun exposure is a good way to avoid recurrences of Sweet’s syndrome. According to the Mayo Clinic, good sun protection practices include the following:

  • Use sunscreen with a sun protection factor (SPF) of at least 15, with both UVA and UVB protection.
  • Wear protective clothing, including items such as wide-brimmed hats, long-sleeved shirts, and sunglasses.
  • Avoid scheduling outdoor activities for midday and early afternoon, when the sun is the strongest.
  • Try to spend time in shady areas when you’re outside.
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Outlook

What is the outlook?

With medication, Sweet’s syndrome is likely to clear up faster than if it’s left untreated. Taking good care of your skin by protecting it from the sun may also help to prevent it from returning.

If you have Sweet’s syndrome, or believe you may have it, your doctor will be able to diagnose and help you find a treatment and prevention plan that is right for you.

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