J Rheum Dis.  2013 Jun;20(3):190-193. 10.4078/jrd.2013.20.3.190.

A Case of Sweet's Syndrome Associated with Rheumatoid Arthritis Involving Multiple Skin Lesions

• Seo YH
• Lee YH
• Ji JD
• Song GG
• Yoo SH
• Ahn J
• Choi SJ

• KMID: 2222760
• DOI: http://doi.org/10.4078/jrd.2013.20.3.190

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.

Keyword

Sweet's syndrome; Rheumatoid arthritis

MeSH Terms

Arthralgia
Arthritis, Rheumatoid
Autoimmune Diseases
Biopsy
Chills
Dermis
Fever
Humans
Inflammatory Bowel Diseases
Leukocytosis
Lower Extremity
Neck
Neutrophils
Skin
Skin Diseases
Sweet Syndrome
Upper Extremity
Vasculitis

Figure

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  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.

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  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).

Reference

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