Sweet Syndrome in Contrast: A Two-Case Comparative Study of Localized and Systemic Manifestations

Sweet syndrome, also known as acute febrile neutrophilic dermatosis, is a rare inflammatory condition characterized by sudden tenderness, erythematous skin lesions, fever, and neutrophilia. It typically presents with raised, erythematous plaques, sometimes accompanied by pseudo-blistering or pustules, primarily on the face, neck, chest, and extremities. The condition can involve extracutaneous manifestations, including ocular, joint, and internal organs. While the absence of vasculitis was initially a diagnostic criterion, recent studies suggest that vasculitis changes occur in up to 74% of cases, challenging the distinction between sweet syndrome and leukocytoclastic vasculitis. Sweet syndrome is associated with infections, autoimmune disorders, malignancies (particularly myelodysplastic syndrome and acute myeloid leukaemia), and pregnancy. Its pathogenesis is thought to be a hypersensitivity reaction. Treatment with systemic corticosteroids often results in rapid improvement; however, recurrence is observed in approximately 25% of cases. Alternative therapies like colchicine, dapsone, and cyclosporine have also shown efficacy.