A patient with sudden, painful red lesions on the face and neck was urgently referred to dermatology after an initial evaluation. Doctors immediately stopped a recently prescribed medication and began thorough testing, including a skin biopsy, blood tests, and screening for antibodies and lupus anticoagulant. Treatment with oral corticosteroids was started to control symptoms, leading to a rapid improvement as pain eased and the lesions became less intense within 48 hours.

Lab results showed “leukocytosis accompanied by neutrophilia” along with positive antibodies and lupus anticoagulant, while other tests were negative. After 20 days, the biopsy confirmed the diagnosis of “Sweet syndrome.” This condition, also called acute febrile neutrophilic dermatosis, is rare and marked by “dense neutrophil infiltrates within the tissue.” It typically appears as painful red bumps or plaques on areas like the face, neck, upper body, and hands, often alongside fever and abnormal blood counts.

The exact cause remains unclear, but it is believed to be an immune reaction. Research suggests it is driven by cytokines that trigger immune cells, often after infections, cancers, or certain medications. Because of this, doctors must rule out serious underlying conditions, including hidden malignancies, before confirming the diagnosis.

Although Sweet syndrome can occur without a known cause, drug-induced cases are more common, especially in women. Medications such as contraceptives, antibiotics, and antihypertensives are often linked, though other drugs may also act as triggers, as seen in this case.

Treatment mainly relies on corticosteroids, which are considered the “gold standard.” Patients عادة improve quickly, with symptoms easing within hours and skin clearing within days. Careful evaluation helped doctors rule out similar conditions like urticaria or lupus, allowing them to confirm the diagnosis and provide the correct treatment.