Sweet???s Syndrome Presenting as Acute Hand Infection

Abstract

As physicians responsible for the treatment of hand lesions, it is important to consider the diagnosis of Sweet's syndrome because these wounds are unresponsive to antibiotics, do not benefit from débridement, and instead, require treatment with steroids.

Thumb Ulcer Presenting As Soft Tissue Infection in a Patient With Sweet’s Syndrome Intolerant To Systemic Corticosteroids: A Case Report

“…1 However, the use of topical corticosteroids as a first-line option in treating these localized lesions is underreported in the literature, as most case reports of localized Sweet’s lesions in the hands have been effectively treated with systemic corticosteroids. 1,7-9,11 In our patient, topical clobetasol was administered prior to systemic dapsone therapy, to which her lesion largely resolved. Administration of clobetasol was an important action to take, as work up for paraneoplastic syndromes and malignancy is required prior to initiating systemic therapy and can cause treatment delays.…”

“…8 Its reputation of an infectious mimicker was emphasized in a 49 patient series reported by O’Halloran and colleagues who were referred to either plastic surgery, dermatology or internal medicine clinics. 11 In nearly all reports, diagnosis was established based on very consistent clinical features: lack of clinical response to antimicrobial therapy, tissue pathology featuring dense neutrophilic infiltrate in the dermis without vasculitis, negative cultures, fevers, leukocytosis, and elevated inflammatory markers.…”