A striking presentation of pustular Sweet syndrome induced by trimethoprim-sulfamethoxazole

C Yoonhee Ryder; Natalie H Matthews; Lori Lowe; Frank Wang

doi:10.1111/ajd.13897

A striking presentation of pustular Sweet syndrome induced by trimethoprim-sulfamethoxazole

Australas J Dermatol. 2022 Nov;63(4):e356-e359. doi: 10.1111/ajd.13897. Epub 2022 Jul 22.

Authors

C Yoonhee Ryder¹, Natalie H Matthews², Lori Lowe^{2

3}, Frank Wang²

Affiliations

¹ University of Michigan Medical School, Ann Arbor, Michigan, USA.
² Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
³ Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan, USA.

Abstract

We describe a strikingly robust presentation of trimethoprim-sulfamethoxazole (TMP-SMX)-induced pustular Sweet syndrome and discuss how to distinguish it from iododerma and other neutrophil-rich conditions. A review of the literature indicates that TMP-SMX-induced Sweet syndrome (SS) may have higher rates of neutrophilia and greater ocular, mucosal, and musculoskeletal involvement compared to SS from other drugs. Recognizing these features and identifying the offending agent are critical for correctly diagnosing TMP-SMX-induced SS in a timely manner.

Keywords: Sweet syndrome; drug eruptions; drug hypersensitivity; neutrophils; potassium iodide; trimethoprim, sulfamethoxazole drug combination.

Publication types

Review

MeSH terms

Humans
Sweet Syndrome* / chemically induced
Sweet Syndrome* / diagnosis
Trimethoprim, Sulfamethoxazole Drug Combination* / adverse effects

Substances

Trimethoprim, Sulfamethoxazole Drug Combination

Grants and funding

TL1 TR002242/TR/NCATS NIH HHS/United States