From the Research
Drug-induced lupus and Sweet's syndrome (also known as Sneddon-Wilkinson disease) are distinct conditions that are not typically directly related. The most recent and highest quality study on drug-induced lupus, published in 2019 1, provides an updated list of medications associated with this condition, but does not establish a direct link with Sweet's syndrome.
Key Points:
- Drug-induced lupus is an autoimmune disorder that mimics systemic lupus erythematosus but is triggered by certain medications, most commonly hydralazine, procainamide, isoniazid, and minocycline.
- When drug-induced lupus is suspected, the first step is to discontinue the offending medication, which usually leads to symptom resolution within weeks to months.
- Treatment may include NSAIDs for joint pain and antimalarials like hydroxychloroquine (200-400mg daily) for skin manifestations while waiting for symptoms to resolve.
- Sweet's syndrome, on the other hand, is a rare neutrophilic dermatosis characterized by sterile pustules that typically affects middle-aged women.
- The first-line treatment for Sweet's syndrome is dapsone (50-200mg daily), which often produces rapid improvement.
- Alternative treatments for Sweet's syndrome include retinoids (acitretin 25-50mg daily), phototherapy, or topical steroids for limited disease.
Management:
- If a patient presents with both conditions, each should be treated separately, with careful attention to medication management to avoid exacerbating either condition.
- The study published in 2019 1 used the WHO pharmacovigilance database to identify the main drugs associated with drug-induced lupus, but did not find a direct link with Sweet's syndrome.
- Other studies, such as those published in 1995 2, 2012 3, 2009 4, and 1985 5, provide additional information on drug-induced lupus, but do not establish a direct link with Sweet's syndrome.