title: Severe Sweet's Syndrome with Elevated Cutaneous Interleukin-1β after Azathioprine Exposure: Case Report and Review of the Literature.
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.
authors: Department of Dermatology, University Hospital, Zurich, Switzerland.
authors: Laurence
authors: L
authors: Imhof
authors: Barbara
authors: B
authors: Meier
authors: Pascal
authors: P
authors: Frei
authors: Jivko
authors: J
authors: Kamarachev
authors: Gerhard
authors: G
authors: Rogler
authors: Antonios
authors: A
authors: Kolios
authors: Alexander A
authors: AA
authors: Navarini
authors: Emmanuel
authors: E
authors: Contassot
authors: Lars E
authors: LE
authors: French
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001379:Azathioprine / Q000009:adverse effects*; D003092:Colitis / Q000188:drug therapy*; D003875:Drug Eruptions / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D053583:Interleukin-1beta / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D016463:Sweet Syndrome / Q000139:chemically induced* / Q000378:metabolism / Q000473:pathology
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D053583:Interleukin-1beta; D001379:Azathioprine; D011241:Prednisone