Sweet’s syndrome is a simpler name for the medical diagnosis Acute Febrile Neutrophilic Dermatosis. It is also called Gomm Button disease. This disease was first described by Dr Robert Douglas Sweet’s.
Sweet’s syndrome is a relatively rare skin condition characterized by an acute onset of a group of clinical signs and symptoms including fever, tender skin lesions like papules and nodules and an increased number of neutrophils (a type of white blood cells).
Sweet’s syndrome is more commonly seen in females than in males, with a ratio of 4:1. Recurrence can be seen in one-third of the patients. The pattern and appearance of Sweet’s syndrome skin lesions are quite similar to erythema nodosum. Therefore, a biopsy needs to be done to arrive at a definite diagnosis.
Typically affects women in the age group of 30-50 years. Classical Sweet’s syndrome is often associated with pregnancy and inflammatory bowel disease. It may also be seen in children and young adults.
This type of Sweet’s syndrome occurs as paraneoplastic variety. Malignancy associated sweet’s syndrome can be associated with acute myeloid leukemia or may represent a skin affection of undiagnosed cancer or recurrence of cancer in patients who have had cancer previously. About 21% of patients of Sweet’s syndrome belong to this variety.
This type of Sweet’s syndrome is often seen in patients who are receiving Granulocyte Colony Stimulating Factor (G-CSF). Certain other drugs associated with Sweet’s syndrome are antibiotics, anti-epileptic drugs, neoplastic drugs and anti-psychotics.
About 16% cases of Sweet’s syndrome are seen in children. Sweet’s syndrome in children are associated with immune deficiency and higher rates of recurrence.
Actual cause and method of occurrence of Sweet’s syndrome are not yet clear. Multiple factors work together to cause Sweet’s syndrome. Clinical studies have shown cytokines to be responsible for the development of Sweet’s syndrome.
Sweet’s Syndrome is also Associated with the Following
As it is mentioned previously, there may be multiple causes of Sweet’s syndrome. Some postulated causes of this rare clinical condition are:
Sweet’s syndrome may present itself in a wide spectrum of diseases and clinical signs and symptoms. If complicated, Sweet’s syndrome can also cause the following clinical conditions to occur
Bones | Osteomyelitis, Acute arthritis, Synovitis |
---|---|
Central Nervous System | Acute meningitis, encephalitis, brain stem lesions, “neuro-Sweet’s” disease, Guillain-Barre syndrome, paralysis, polyneuropathy and psychiatric symptoms |
Ears | Nodules, pustules and plaques affecting the middle or inner ear and tympanic membrane |
Eyes | Conjuctival lesions, hemorrhage, infections of eye, glaucoma, ocular congestion and swelling. |
Kidneys | Glomerulonephritis, hematuria or polyuria |
Intestines | Extensive neutrophilic inflammation, infection of the ileus, pan-colitis |
Liver | Hepatomegaly, liver enzyme abnormalities and neutrophilic inflammation of the liver |
Heart | Stenosis and infection of the aorta, cardiomegaly, heart failure, vascular dilatation. |
Lungs | Bronchitis, neutrophilic inflammation of the airways, pulmonary edema. |
Mouth | Aphthous ulcers, vesicles in the oral mucosa, inflammation and ulceration of the gums, swelling of the tongue, gums and oral mucosa |
Muscles | Neutrophilic inflammation of tendons, muscles and synovial space around joints |
Spleen | Splenomegaly |
Eye involvement is common in a classical variety of Sweet’s syndrome. Oral lesions are commonly seen in Sweet’s syndrome associated with blood disorders.
A classical variant of Sweet’s syndrome, if left untreated, resolves completely within a few weeks to a month without any scar formation. In malignancy-associated type, even after complete cure of cancer, Sweet’s syndrome may still persist in the patient. Recurrence of skin lesions after complete cure of cancer may indicate relapse of malignancy.
In drug-induced type, immediate cessation of offending drug results in spontaneous resolution of skin lesions.
For any kind of clinical condition, treating the cause is as important as a diagnosis. Corticosteroids, topical ointments, potassium iodide, colchicine and antibiotics or anti-inflammatory drugs are often used for medical management. In severe cases, surgical intervention may also be required.
Medically Reviewed By
Dr. Himanshi is a Homoeopathic consultant and currently working as a lecturer in Post-graduate faculty of Homeopathy, Parul University, Vadodara. Completed BHMS and MD in Homeopathy in January 2018 and also has a clinical experience of about 6 years. Personal interests include reading, spending time with family and traveling.
Internal bleeding is a medical condition where blood escapes from damaged blood vessels and accumulates…
Serotonin, commonly referred to as the "feel-good" neurotransmitter, plays a critical role in regulating mood,…
Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are two neurodevelopmental conditions that, while distinct,…
The year 2024 has seen a significant Listeria outbreak, raising alarms across several countries. Listeria…
Metabolic conditioning (MetCon) has gained significant attention in the fitness world, often hailed as a…
Cooking oils are a staple in every kitchen, playing a crucial role in the flavor,…