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The Clinical Picture

Fever, rash, pruritus: Sweet syndrome

Giovani M. Zelada, MD and Paul B. Aronowitz, MD
Cleveland Clinic Journal of Medicine July 2021, 88 (7) 371-373; DOI: https://doi.org/10.3949/ccjm.88a.20053
Giovani M. Zelada
Internal Medicine-Psychiatry Residency Program, University of Texas Southwestern Medical Center, Dallas, TX
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Paul B. Aronowitz
Department of Internal Medicine, University of California Davis School of Medicine, Sacramento, CA
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    Figure 1

    On the patient’s back were multiple firm erythematous nodules with pustular heads, as well as several erythematous plaques.

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    Figure 2

    The patient’s lower extremities.

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    Figure 3

    The patient’s right arm.

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    TABLE 1

    Diagnostic criteria for classic Sweet syndrome

    The diagnosis requires both major and minor criteria:
    Major criteria (both are required)
    Abrupt onset of painful erythematous plaques or nodules
    Histopathologic evidence of a dense neutrophilic infiltrate without evidence of leukocytoclastic vasculitis
    Minor criteria (2 of 4 are required)
    Temperature > 38°C (100.4°F)
    Association with an underlying hemoproliferative disorder, inflammatory disease, or solid tumor
    OR
    Preceded by an upper respiratory or gastrointestinal infection
    Excellent response to treatment with systemic corticosteroids or potassium iodide
    Abnormal laboratory values at presentation (3 of 4 are required):
    • Erythrocyte sedimentation rate > 20 mm/hour

    • Elevated C-reactive protein

    • White blood cell count > 8.0 × 109/L

    • Neutrophils > 70%

    • Adapted from information in references 7 and 8.

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Cleveland Clinic Journal of Medicine: 88 (7)
Cleveland Clinic Journal of Medicine
Vol. 88, Issue 7
1 Jul 2021
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Fever, rash, pruritus: Sweet syndrome
Giovani M. Zelada, Paul B. Aronowitz
Cleveland Clinic Journal of Medicine Jul 2021, 88 (7) 371-373; DOI: 10.3949/ccjm.88a.20053

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Fever, rash, pruritus: Sweet syndrome
Giovani M. Zelada, Paul B. Aronowitz
Cleveland Clinic Journal of Medicine Jul 2021, 88 (7) 371-373; DOI: 10.3949/ccjm.88a.20053
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    • SWEET SYNDROME: KEY FEATURES
    • STEROIDS ARE FIRST-LINE THERAPY
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