Sequential occurrence of recurrent Sweet syndrome and erythema nodosum without an underlying secondary cause: a case report

Hansika Peiris,Chamila Mettananda,Ahamed Uwyse

doi:10.1186/s13256-022-03282-1

Hansika Peiris, Chamila Mettananda + Show 1 more

Open Access

https://doi.org/10.1186/s13256-022-03282-1

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Abstract

BackgroundSweet syndrome is a rare cause of acute fever and painful erythematous skin plaques. Erythema nodosum is acute or chronic tender erythematous skin nodules of bilateral shins. The concurrent presence of both dermatoses is rare but reported in the literature. There are no reported cases of recurrent and sequential Sweet syndrome and erythema nodosum without an underlying secondary cause.Case presentationWe report the case of a 64-year-old Asian woman, who had possible Sweet syndrome 12 years ago and biopsy-proven erythema nodosum 5 years ago, presenting with an acute episode of Sweet syndrome. Extensive investigations did not reveal any underlying secondary cause.ConclusionsRecurrent Sweet syndrome and sequential presence with erythema nodosum raises suspicion if Sweet syndrome and erythema nodosum are different presentations of one disease, which warrants further study. This case proves that recurrent Sweet syndrome and erythema nodosum can occur in healthy individuals without an underlying malignancy or secondary cause.

Highlights

Sweet syndrome is a rare cause of acute fever and painful erythematous skin plaques
Recurrent Sweet syndrome and sequential presence with erythema nodosum raises suspicion if Sweet syndrome and erythema nodosum are different presentations of one disease, which warrants further study. This case proves that recurrent Sweet syndrome and erythema nodosum can occur in healthy individuals without an underlying malignancy or secondary cause
The patient was followed up 9 months after the current presentation, and she was asymptomatic with an erythrocyte sedimentation rate (ESR) of 20 mm after 1 hour

Summary

Conclusions

There are no reported cases of recurrent and sequential SS and EN without an underlying secondary cause. We report a 64-year-old, otherwise healthy, Asian woman with sequential recurrent SS and EN over 12 years without an underlying secondary cause. Recurrent SS and sequential presence with EN raise the suspicion of SS and EN being different presentations of one disease, which warrants further study. This case proves that recurrent SS and sequential SS and EN may occur in healthy individuals without an underlying malignancy or secondary cause

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