A case of simultaneously developed sweet's syndrome and systemic lupus erythematosus in a man

Abstract

Introduction: Sweet's syndrome is characterized by the development of tender, erythematous plaques, fever, arthralgia and leukocytosis. Sweet's syndrome is reported to be associated with underlying infections, malignant neoplasms, pregnancy, drugs, and autoimmune diseases. However, Sweet's syndrome associated with systemic lupus erythematosus has been rarely reported. Although both Sweet’s syndrome and systemic lupus erythematosus predominantly occur in women, we are reporting a case of simultaneously developed Sweet's syndrome and systemic lupus erythematosus in a man. Case Report: A 48­year­old previously healthy man was admitted for intermittent fevers, arthralgias, and eruption. Laboratory investigations revealed elevated C­reactive protein, lymphocytopenia, and low complements with elevated immune complex. Antinuclear antibodies, anti­DNA antibodies were positive. Systemic lupus erythematosus was diagnosed based on the presence of arthritis, lymphopenia, anti­DNA antibodies and antinuclear antibodies. A biopsy specimen from an erythematous papule from the right sole showed a slight lichenification and an infiltration of neutrophils and lymphocytes in dermis without leukocytoclastic vasculitis. Thus, this case also met the modified criteria for Sweet’s syndrome proposed by von den Driesch. Prednisolone was begun at a dose of 20 mg/day, resulting in diminishing skin eruption and resolution of arthralgia. Conclusion: Sweet's syndrome is categorized into classical, drug­induced, and malignancy­associated form. Only one case of concurrence of classical Sweet’s syndrome and systemic lupus erythematosus has been reported in a man. This is the second case of coincidence of classical Sweet’s syndrome and systemic lupus erythematosus in an adult man.