Hydroxychloroquine-induced Sweet's Syndrome: A Case Report and Literature Review

Area of Science:

• Dermatology
• Immunology
• Pharmacology

Background:

• Sweet's syndrome, or acute febrile dermatosis, is a neutrophilic dermatosis characterized by fever, specific skin lesions, neutrophilia, and dermal neutrophilic infiltrate without vasculitis.
• Its pathophysiology involves an auto-inflammatory component potentially linked to inflammasome gene mutations, and it is classified into classic, malignancy-associated, and drug-induced forms.
• While typically responsive to steroids, recurrences are frequent, necessitating thorough etiological investigation.

Observation:

• This report presents an exceptionally rare case of Sweet's syndrome induced by hydroxychloroquine.
• The literature review identified only three prior cases of hydroxychloroquine-induced Sweet's syndrome and one case induced by chloroquine.
• Diagnosing the etiology can be challenging, particularly in elderly patients due to potential confounding factors.

Findings:

• Hydroxychloroquine is identified as a rare but possible trigger for Sweet's syndrome.
• The case underscores the importance of considering drug-induced causes in the differential diagnosis of Sweet's syndrome.
• The study highlights diagnostic difficulties in identifying the specific etiological factors, especially in complex patient populations.

Implications:

• Further research is crucial to elucidate the pathophysiology of Sweet's syndrome.
• Improved diagnostic strategies are needed to facilitate timely etiological identification.
• Enhanced understanding will aid in developing more effective treatment and prevention strategies for recurrent cases.