Severe Sweet's Syndrome with Elevated Cutaneous Interleukin-1β after Azathioprine Exposure: Case Report and Review of the Literature

Dermatology : International Journal for Clinical and Investigative Dermatology
Laurence ImhofLars E French

Abstract

Sweet's syndrome (SS) is a dermatosis with systemic symptoms characterized by tender, red nodules or papules, occasionally covered with vesicles, pustules or bullae, usually affecting the upper limbs, face and neck. SS is frequently observed in patients with leukemia or connective tissue diseases, while it is rather seldom in patients with inflammatory bowel disease. The exact pathogenesis of SS is only partially understood. We report the case of a 50-year-old patient with indeterminate colitis, presenting with a febrile diffuse papulopustular and necrotizing skin eruption that healed with significant scarring and appeared 14 days after onset of treatment with azathioprine. Histological examination revealed the presence of features typical of SS, gene expression analysis very high levels of interleukin-1β (IL-1β) mRNA in lesional skin, and immunohistochemistry high levels of IL-1β at the protein level. SS associated with azathioprine is being increasingly reported and is reviewed herein.

Citations

Dec 2, 2015·Seminars in Immunopathology·Alexander A NavariniLars E French
Mar 12, 2017·Journal of General Internal Medicine·Vivian TienPaul B Aronowitz
Dec 3, 2016·The British Journal of Dermatology·T K SatohL E French
Mar 30, 2018·The British Journal of Dermatology·A A Navarini, L E French
Jun 8, 2017·Frontiers in Pharmacology·Gabriele FeniniLars E French
Apr 19, 2020·Der Pathologe·Sigrid M C Möckel, Dieter Metze
Apr 26, 2020·Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete·L Feldmeyer, A A Navarini
Nov 1, 2016·Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete·B MeierL E French
May 30, 2019·Frontiers in Immunology·Angelo V MarzanoMassimo Cugno
Apr 19, 2019·American Journal of Clinical Dermatology·Annika Havnaer, George Han
Apr 2, 2019·Frontiers in Immunology·Michael S Heath, Alex G Ortega-Loayza
Feb 24, 2021·Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG·Barbara Meier-Schiesser, Lars E French
Feb 20, 2021·Journal of the American Academy of Dermatology·Roger HaberMilissa Makhlouf
Apr 24, 2021·Journal of Crohn's & Colitis·Joseph SleimanFlorian Rieder

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