Sweet's Syndrome

Reviewed by: HU Medical Review Board | Last Reviewed: July 2018.

Sweet’s syndrome, also known as acute febrile neutrophilic dermatosis, causes tender, red skin lesions. There are three different categories of Sweet’s syndrome: Classical, malignancy-associated, and drug-induced. Classical Sweet’s syndrome is the most common type and has been associated with inflammatory bowel disease (IBD), including both Crohn’s disease and ulcerative colitis.1 Some researchers have suggested that Sweet’s syndrome may be an extraintestinal (occurring outside of the intestines) manifestation of IBD.2

What are the symptoms of Sweet’s syndrome?

Classical Sweet’s syndrome usually develops after a respiratory or gastrointestinal infection. The symptoms include skin lesions (bumps or raised areas), fever, fatigue, headaches, muscle pain, and joint pain. The skin lesions are often painful or tender and may be raised, flat, irregularly shaped, and inflamed. The lesions tend to merge together forming larger clusters. The lesions of Sweet’s syndrome may occur on the arms, legs, face, neck, thighs, or trunk.3,4

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Sweet syndrome can potentially extend beyond the skin and involve other organs of the body. It can manifest in nearly any organ, but is most commonly seen in the eyes in the form of conjunctivitis (inflammation of the skin around the eyes) or episcleritis (inflammation of the tissue that covers the whites of the eyes).3

What other conditions are associated with Sweet’s syndrome?

Classical Sweet’s syndrome usually occurs in women between the ages of 30 and 50 years, although it can occur in people of any age. It has been linked to individuals with IBD and women who are pregnant. Malignancy-associated Sweet’s syndrome can occur in people with certain forms of cancer and is most commonly related to acute myelogenous leukemia (AML). Drug-induced Sweet’s syndrome most often occurs in people who have been treated with granulocyte-colony stimulating factor (G-CSF), which are received during chemotherapy to help boost the body’s production of white blood cells. Less commonly, other medications, including certain antibiotics and contraceptives, have also been linked with Sweet’s syndrome.1

How is Sweet’s syndrome evaluated?

A dermatologist (a doctor who specializes in disorders of the skin) may be able to diagnose Sweet’s syndrome with a physical exam. Blood tests and a skin biopsy will likely be performed to confirm a diagnosis of Sweet’s syndrome and to help rule out other skin disorders that may have similar symptoms.3,5

How is Sweet’s syndrome treated?

In some instances, classical Sweet’s syndrome may resolve without treatment, but may last for several weeks to months. For those with malignant-associated and drug-induced Sweet’s syndrome, treatment of the cancer or discontinuance of the drug often resolve the symptoms. The treatment for Sweet’s syndrome is aimed at the specific symptoms the person is experiencing. The most common treatment used for Sweet’s syndrome is corticosteroids, which can help relieve symptoms rapidly. Corticosteroids that may be used for Sweet’s syndrome come in different formulations, including pills, creams or ointments, and injections.3,5

There are other treatment options that may be used, but because Sweet’s syndrome is rare, there have been no large-scale clinical trials to evaluate treatments. Sweet’s syndrome may reappear even with effective treatment, and some people may experience a flare of symptoms as corticosteroids are tapered off.1 Most people with Sweet’s syndrome heal without scars unless the skin lesions developed into ulcers or open sores. In some people, the discoloration of the skin where the lesions occurred may remain for several months.3