Sweet's Syndrome Unveiling a Primary Cervical Malignancy: A Case Report

Sweet's syndrome (SS) is a relatively rare dermatological condition typically presenting with erythematous tender plaques, papules, nodules, or pustules accompanied by fever, asymmetric polyarthralgia, and other systemic features. Elevated inflammatory markers and white blood cell counts are also commonly seen in SS. Dense neutrophilic infiltration in the dermis is a cardinal feature of SS. A 52-year-old woman presented with a five-month-long history of fever, easy fatigability, multiple painful skin lesions over her scalp, face, trunk, and limbs, and a history of multiple joint pain for three months. Examination revealed tender, erythematous papules, plaques, and nodules which spread from her scalp to involve almost the entire body. Hematological workup unmasked an overlap between anemia of chronic disease and autoimmune hemolytic anemia. Her inflammatory markers and lactate dehydrogenase (LDH) were also elevated. The anti-nuclear antibody (ANA) test revealed 1:100 titers but the ANA profile failed to point toward a concrete rheumatological cause. After ruling out more common causes of fever with rash, a skin biopsy helped us to diagnose SS conclusively. A diagnosis of SS necessitated a hunt for the cause. Ultrasonography of the abdomen alarmed us to a suspicious cervical mass which was confirmed as a FIGO (International Federation of Gynecology and Obstetrics) grade IIb neoplasia by an MRI of the pelvis. Histopathological examination established a diagnosis of moderately differentiated squamous cell carcinoma. SS was successfully treated with colchicine. Our case is unique in the sense that SS was the first feature of a newly diagnosed case of cervical cancer which is already an exceptionally rare cause of SS. There ought to be a greater awareness regarding both SS and its association with malignancy. It's pertinent that we look out for cancer when more common causes of SS do not fit the clinical picture.