Sweet's Syndrome: A Case of Fever and Painful Erythematous Nodules Following a Viral-Like Illness

Sweet's syndrome, or acute febrile neutrophilic dermatosis, is an uncommon inflammatory disorder characterized by the abrupt onset of fever, neutrophilia, and painful erythematous skin lesions. We report the case of a previously healthy woman who developed high fever, severe migratory arthralgias, and multiple tender erythematous nodules with pustular features following a recent viral-like illness. Laboratory evaluation revealed marked inflammatory activation with otherwise unremarkable hematological and biochemical parameters. A broad diagnostic investigation excluded infectious, autoimmune, endocrine, and neoplastic causes. Skin biopsy demonstrated a dense neutrophilic infiltrate without vasculitis, confirming Sweet's syndrome. Systemic corticosteroid therapy led to rapid and sustained resolution of fever, arthralgias, and cutaneous lesions. This case illustrates the importance of early recognition and prompt biopsy in patients with acute febrile dermatoses to guide appropriate treatment and avoid unnecessary antimicrobial therapy.