Letter to the Editor

Sweet Syndrome Associated With Erythema Nodosum: Are They Different Manifestations of the Same Disease?

Authors: Gonenc Kocabay, MD, Atahan Cagatay, MD, Asli Karadeniz, MD


To the Editor:

Sweet Syndrome (SS, acute febrile neutrophilic dermatosis)is a rarely seen disease that includes abruptly developing painful papullonodular or plaque-shaped erythematous lesions associated with systemic findings such as malaise, fever, arthralgia, conjunctivitis and episcleritis, and histologically characterized by edema on the upper dermis and intense neutrophilic infiltration. SS is a reactive dermatitis which may be an early and associated manifestation of various diseases such as malignancies (especially hematological) but may also occur in healthy humans. Erythema nodosum is usually characterized by abruptly developing, painful, erythematous nodules on the front side of the tibia. It is manifested histologically as septal granulomatous panniculitis. These dermatoses are rarely seen together.1

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1. Singh RK. Acute febrile neutrophilic dermatosis following tuberculous infection. J Assoc Physicians India 2002;50:1322–1323.
2. Waltz KM, Long D, Marks JG Jr, et al. Sweet’s syndrome and erythema nodosum: the simultaneous occurrence of 2 reactive dermatoses. Arch Dermatol 1999;135:62–66.
3. Hönigsmann H, Cohen PR, Wolff K. Inflammatory and neoplastic disorders of the dermis. In: Freedberg IM, Eisen AT, Wolff KK, et al (eds). Dermatology in General Medicine. 5th ed. New York, McGraw-Hill Co, 1999, pp 1117–1123.
4. Spaz SA. Erythema nodosum in Sweet’s syndrome. Cutis 1985;35:327–330.
5. Bondi EE, Margolis DJ, Lazarus GS. Panniculitis. In: Freedberg, IM, Eisen AZ, Wolff K, et al (eds). Dermatology in General Medicine. 5th ed. New York, McGraw-Hill, 1999, pp 1275–1289.