Introduction:
Sweet syndrome, also known as acute febrile neutrophilic dermatosis, is a rare inflammatory skin condition characterized by the sudden onset of painful, erythematous plaques or nodules, often accompanied by fever and elevated white blood cell count. While the exact cause remains unclear, it has been associated with various triggers, including infections, malignancies, and certain medications.
Case Presentation:
A 58-year-old female with a history of asthma and recent initiation of a new inhaler therapy presented to her primary care physician with complaints of fever, malaise, and the development of tender, erythematous skin lesions on her upper extremities and face. Laboratory investigations revealed elevated white blood cell count with neutrophilia, and skin biopsy confirmed the diagnosis of Sweet syndrome.
Discussion:
This case highlights the potential for inhaler therapies, particularly those containing corticosteroids or other immunomodulatory agents, to induce Sweet syndrome. While corticosteroids are commonly used in the management of asthma, their role in triggering Sweet syndrome underscores the importance of vigilant monitoring for adverse reactions, especially when initiating new therapies.
Management:
The patient was promptly referred to a dermatologist, who initiated treatment with systemic corticosteroids. Within 48 hours, there was a significant improvement in both systemic symptoms and skin lesions. The patient was advised to continue with the prescribed inhaler therapy, with close follow-up to monitor for any recurrence of symptoms.
Conclusion:
This case underscores the importance of considering drug-induced Sweet syndrome in patients presenting with new-onset skin lesions and systemic symptoms following the initiation of new medications, including inhaler therapies. Early recognition and appropriate management are crucial to prevent complications and ensure optimal patient outcomes.
