SWEET syndrome. A case from clinical practice

Spaska H.O.¹, Bakun T.V.¹, Uzun S.V.², Lurina N.A.¹, Hryshchenko K.M.¹

• ¹National Military Medical Clinical Centr «Main Military Clinical Hospital», Kyiv
• ²Ukranian Military Medical Academy, Kyiv

Summary. Neutrophilic dermatoses are a heterogeneous group of disorders characterized by both localized and generalized skin involvement, with or without systemic manifestations. These conditions require close attention due to the severity and intensity of symptoms, as well as their possible predictive role in relation to neoplastic processes. A common feature of all neutrophilic dermatoses is the characteristic proliferation of neutrophilic granulocytes in the dermis. The clinical diagnosis must be confirmed by histopathological examination, and treatment should be provided according to disease severity and the rool cause. Neutrophilic dermatoses include Sweet syndrome (SS), gangrenous pyoderma, Behcet’s disease, neutrophilic urticaria, subcorneal pustular dermatosis, palmoplantaris pustulosis, acrodermatitis Allopo, acute generalized exentematous pustulosis, infant pustulosis, etc. [1]. Objective. In this article, we describe a case of Sweet syndrome, or acute febrile neutrophilic dermatosis, in a 59-year-old man in order to highlight the importance of timely diagnosis of this condition. The most common manifestation of this disease is skin involvement; however, other organs and systems may also be affected. A differential diagnosis was performed with other systemic connective tissue diseases, as well as myelo- and lymphoproliferative disorders that present with a similar clinical picture. Successful treatment of this patient is also described. Conclusions. Timely diagnosis of Sweet syndrome requires a high level of clinical suspicion not only from rheumatologists but also from doctors of other specialties (dermatologists, therapist, and family doctors). Skin biopsy may be used for differential diagnosis with other dermatological conditions and systemic connective tissue diseases. Oncological screening is mandatory in such patients. Glucocorticoids are the treatment of choice for Sweet syndrome. In cases of intolerance or insufficient efficacy, the addition of a steroid-sparing agent (such as methotrexate or others) may be considered. The choice of therapy depends on the severity of skin lesion, chronicity of the disease, and the presence of involvement of other organs and systems.