Sweet Syndrome in Pediatrics. A Case report

Abstract

Introduction: Sweet’s syndrome is a very rare dermatosis in pediatrics, of unknown pathogenesis, clinically characterized by fever, neutrophilia, raised and painful plaques on the skin of the face, neck, and limbs, and histologically by dermal infiltration of neutrophils.

Objective: To present a clinical case of Sweet Syndrome in a pediatric patient.

Clinical Case: 3-years-old female child, with history of complex chromosomopathy 46XX add(8), with a 7-day history of plaques and blisters on the back and later also on the limbs, associated with high fever, without response to antibiotic treatment prescribed due to suspicion of bullous impetigo. Physical examination showed multiple erythematousviolaceous plaques, with bullous center on the back, upper and lower limbs, along with plaques and erythematous nodules on the left arm and thigh. Laboratory tests showed leukocytosis with neutrophilia (absolute neutrophil count 45954/mm3) and elevated CRP (347 mg/L). Biopsy of skin lesions reported histopathological findings compatible with Sweet’s Syndrome. Treatment with prednisone 1 mg/kg/day was indicated with good clinical response. After two weeks of treatment, she presented crusty plaques of smaller size, without bullous lesions.

Conclusions: Sweet’s syndrome is an uncommon dermatosis in pediatrics, therefore, a high index of suspicion should be held in the presence of fever associated with persistent skin lesions. While most cases are idiopathic, screening for associated conditions, mainly proliferative disorders, infections, and immunodeficiencies must be performed