Een meisje met een pijnlijke huiduitslag: Het syndroom van Sweet

An eight year old girl was referred to the hospital with an acute onset of tender erythematous skin lesions on her lower extremities and swollen joints. Biopsy of the lesions showed a perivascular dense infiltrate with neutrophils, confirming Sweet's syndrome. It is a neutrophilic dermatosis, which usually presents in adults. Only 8% of the cases concerns children. The pathogenesis of Sweet's syndrome may be multifactorial and still remains to be definitively established. Classical or idiopathic Sweet's syndrome may be associated with infection (bacterial, viral as parasitic), immunologic disease (like rheumatic arthritis, dermatomyositis, inflammatory bowel disease) or pregnancy. Furthermore there is variant induced by medication (granulocyt colony-stimulating factor, oral contraceptives, trimethoprim-sulfamethoxazole, furosemide) and a variant associated with malignancy particularly with hematologic malignancy such as myeloid leukemia and non-Hodgkin lymphoma. Systemic corticosteroids are the therapeutic gold standard together with supportive care. The associated disorders seem to determine the prognosis.