Sweet Syndrome Associated With New-Onset Systemic Lupus Erythematosus in a 25-Year-Old Man

Sweet syndrome (SS) is a reactive neutrophilic process characterized by tender, erythematous papules and plaques, fever, and leukocytosis and is associated with underlying infections, inflammatory diseases, and malignant neoplasms. To our knowledge, only 2 cases of SS associated with new-onset systemic lupus erythematosus (SLE) have been reported—one in an adult woman and the other in a 14-year-old girl.1,2 We report the first case in an adult man. Report of a Case A 25-year-old previously healthy man was admitted for intermittent fevers (temperature readings to 39.4°C), arthralgias, chest pain, and eruption. He reported 7 months of malaise and a previous admission for chest pain during which a chest computed tomographic (CT) scan revealed bilateral axillary lymphadenopathy. A dermatologist was consulted to evaluate a malar eruption and multiple, red, tender plaques with central vesiculopustules (Figure 1). The patient denied taking any new medications prior to the onset of his eruption. Initial blood testing showed leukopenia with neutrophilia and lymphopenia, an elevated erythrocyte sedimentation rate and C-reactive protein level, and negative findings for enzyme-linked immunosorbent assay for human immunodeficiency virus. A biopsy specimen of 1 o