title: Diffuse febrile dermatosis in a patient with active ulcerative colitis under treatment with steroids and azathioprine: a case of Sweet's syndrome. Case report and review of literature.
abstract: Ulcerative colitis is an inflammatory bowel disease often associated with extra-intestinal manifestations, such as dermatological disorders. Of these, the most frequent are erythema nodosum and pyoderma gangrenosum, the two neutrophilic forms of dermatosis. Another is Sweet' s syndrome, which results in a sudden eruption of tender, raised erythematous or violaceous plaques/papules or nodules, less frequent vesicles, pustules or bullae, involving face, neck, arms and trunk. This skin disorder is frequently observed in patients with leukaemia or connective tissue diseases, while it is very rare in patients with inflammatory bowel disease. The present report deals with the case of a febrile diffuse skin eruption in a 53-year-old patient with moderately active ulcerative colitis after few days' treatment with steroids and azathioprine. At first, the dermatosis was addressed to an idiosyncrasy to azathioprine, which was, therefore, promptly discontinued. Histological examination of skin biopsies revealed the presence of features typical of a Sweet's syndrome. The eruption gradually improved as well as the patient's general condition, until complete regression was achieved following steroid treatment.
authors.affiliation: Department of Clinical Science, Gastroenterology Unit, La Sapienza University, Viale del Policlinico 157, 00161 Rome, Italy.
authors.forename: O A
authors.initials: OA
authors.lastname: Paoluzi
authors.forename: P
authors.initials: P
authors.lastname: Crispino
authors.forename: A
authors.initials: A
authors.lastname: Amantea
authors.forename: R
authors.initials: R
authors.lastname: Pica
authors.forename: F
authors.initials: F
authors.lastname: Iacopini
authors.forename: A
authors.initials: A
authors.lastname: Consolazio
authors.forename: V
authors.initials: V
authors.lastname: Di Palma
authors.forename: M
authors.initials: M
authors.lastname: Rivera
authors.forename: P
authors.initials: P
authors.lastname: Paoluzi
mesh_terms: D001379:Azathioprine / Q000008:administration & dosage / Q000009:adverse effects*; D003093:Colitis, Ulcerative / Q000150:complications / Q000188:drug therapy*; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects*; D016463:Sweet Syndrome / Q000139:chemically induced* / Q000175:diagnosis
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D001379:Azathioprine; D011241:Prednisone