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Clozapine and Sweet's syndrome: case report
Apphia Bunting1, Daniel Silman2, Minesh Karia2
1Oxford Health Foundation Trust, Warneford Hospital, Oxford, UK.
Bjpsych Open
|September 4, 2023
Summary
Clozapine, an antipsychotic, can induce Sweet's syndrome, a rare skin condition. This case highlights the diagnostic challenges and successful treatment with corticosteroids and drug withdrawal.
Area of Science:
- Dermatology
- Psychiatry
- Pharmacology
Background:
- Sweet's syndrome is an acute febrile neutrophilic dermatosis.
- It can be triggered by infections, malignancies, or medications.
- Clozapine is an atypical antipsychotic used for treatment-resistant schizophrenia and schizoaffective disorder.
Purpose of the Study:
- To report a case of Sweet's syndrome induced by clozapine.
- To discuss the diagnostic challenges in identifying drug-induced Sweet's syndrome.
- To highlight the management strategies for this condition.
Main Methods:
- A patient with schizoaffective disorder developed symptoms after starting clozapine.
- Skin biopsy confirmed Sweet's syndrome.
- Causative agent identification involved considering various differential diagnoses.
Main Results:
- The patient presented with fever, elevated inflammatory markers, and a maculopapular rash.
- Clozapine was identified as the likely trigger for Sweet's syndrome.
- Treatment with prednisolone and clozapine withdrawal led to symptom resolution.
Conclusions:
- Drug-induced Sweet's syndrome is a potential adverse effect of clozapine.
- Accurate diagnosis requires careful consideration of drug history and exclusion of other causes.
- Management involves prompt withdrawal of the offending agent and appropriate corticosteroid therapy.
Keywords:
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