Sweet's syndrome complicating ulcerative colitis: a rare association

Area of Science:

• Dermatology
• Gastroenterology
• Internal Medicine

Background:

• Sweet's syndrome (SS) is a neutrophilic dermatosis characterized by fever, neutrophilia, and painful skin lesions.
• It is an uncommon extra-intestinal manifestation of inflammatory bowel disease (IBD), more frequently associated with Crohn's disease than ulcerative colitis (UC).
• SS typically affects women with colonic disease and active IBD.

Observation:

• A 39-year-old woman with moderate ulcerative colitis on mesalazine presented with acute fever, painful skin lesions, episcleritis, and neck pain.
• Skin biopsies revealed a neutrophil-rich infiltrate in the papillary dermis, consistent with SS.
• No leukocytoclastic vasculitis or panniculitis was observed.

Findings:

• The patient's symptoms and skin lesions resolved effectively with systemic corticosteroid treatment.
• The case demonstrates a clear association between ulcerative colitis flare and the onset of Sweet's syndrome.
• Histopathological findings confirmed Sweet's syndrome without other complicating inflammatory processes.

Implications:

• This case underscores the importance of considering Sweet's syndrome in patients with inflammatory bowel disease presenting with characteristic dermatological and systemic symptoms.
• Early recognition and appropriate treatment, such as corticosteroids, can lead to rapid symptom resolution.
• Further research into the pathogenesis of SS in IBD may reveal novel therapeutic targets.