Department of Internal Medicine, MeQrez General Hospital, Addis Ababa, Ethiopia.
Department of Dermatology, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.
J Med Case Rep. 2024 Oct 11;18(1):492. doi: 10.1186/s13256-024-04848-x.
Sweet syndrome (acute febrile neutrophilic dermatosis) is an uncommon inflammatory disorder characterized by the abrupt appearance of painful, edematous, and erythematous papules, plaques, or nodules on the skin. There are various subtypes, such as classical, drug-induced, malignancy-associated, and the less common variant giant cellulitis-like Sweet syndrome. This case is unique due to its presentation of the giant cellulitis-like variant of Sweet syndrome in a patient from Ethiopia. The unusual distribution of the skin lesions and the initial lack of response to antibiotics make this case particularly noteworthy. It underscores the importance of considering Sweet syndrome in differential diagnoses when faced with atypical skin manifestations and ineffective antibiotic treatment. This contribution adds valuable insights to the scientific literature by highlighting the need for heightened awareness of this rare variant and improving diagnostic accuracy in similar clinical scenarios.
A 60-year-old Ethiopian male patient who presented to the accident and emergency department with a 5-day history of fever, chills, sweating, and rigor accompanied by a reddish skin color change around the anterolateral region of the right chest wall. On physical examination, there were erythematous, indurated tender plaques with ill-defined borders over the right antero- and posterolateral chest wall with extension to the lateral part of the right neck and medial aspect of the right arm. Subsequently, the patient was started on antibiotics, but there was a suboptimal response. Skin biopsy revealed features suggestive of giant cellulitis-like Sweet syndrome. He was then started on steroids, which significantly improved his symptoms.
A cautious stance is essential when identifying Sweet syndrome in individuals displaying erythematous plaque-like skin lesions in atypical areas of the body with uneven distribution. Such presentation may signal Sweet syndrome rather than a common infection. If conventional treatments, such as antibiotics, fail to resolve symptoms, consider Sweet syndrome as a potential diagnosis. This approach ensures timely and appropriate treatment, preventing treatment delay and misdiagnosis.
Sweet 综合征（急性发热性嗜中性皮病）是一种不常见的炎症性疾病，其特征为突然出现疼痛、肿胀和红斑性丘疹、斑块或结节状皮损，发生于皮肤。有多种亚型，如经典型、药物诱导型、与恶性肿瘤相关型和较少见的巨大细胞性蜂窝织炎样 Sweet 综合征型。本例由于是来自埃塞俄比亚的患者发生巨大细胞性蜂窝织炎样 Sweet 综合征型，故具有独特性。皮肤损害的不典型分布和初始对抗生素治疗无反应使得该病例尤其值得关注。这突显了当遇到不典型皮肤表现和抗生素治疗无效时，考虑 Sweet 综合征作为鉴别诊断的重要性。本病例为该罕见变异型提供了有价值的科学文献补充，提高了在类似临床情况下的诊断准确性。
一名 60 岁的埃塞俄比亚男性患者，因发热、寒战、出汗和打冷战 5 天就诊于急症室，右侧前胸壁前外侧区域出现皮肤颜色变红。体格检查发现右侧前胸壁前、后外侧有红斑性、硬结性、触痛性斑块，边界不清，延伸至右侧颈部外侧和右侧手臂内侧。随后，患者开始接受抗生素治疗，但效果不佳。皮肤活检显示特征性巨大细胞性蜂窝织炎样 Sweet 综合征。随后开始使用类固醇治疗，症状明显改善。
当在身体非典型部位出现红斑样斑块状皮损且分布不均匀的个体中识别 Sweet 综合征时，需保持谨慎。这种表现可能提示 Sweet 综合征而非常见感染。如果常规治疗（如抗生素）无法缓解症状，应考虑 Sweet 综合征作为潜在诊断。这种方法可确保及时和适当的治疗，防止治疗延误和误诊。
