From the Guidelines
The treatment of Sweet's syndrome primarily involves systemic corticosteroids, which have been reported to be effective in managing the condition. According to the study published in the Journal of Crohn's and Colitis in 2013 1, Sweet's syndrome is characterized by tender, red inflammatory nodules or papules, and systemic corticosteroids have been shown to be effective in treating this condition.
Key Considerations
- The rash is mostly associated with active disease, and therefore, treatment should be aimed at managing the underlying condition as well.
- There is a strong predilection for women and patients with colonic involvement and other extraintestinal manifestations, which should be taken into consideration when treating Sweet's syndrome.
- The study suggests that systemic corticosteroids are the primary treatment option, but does not provide specific details on dosage or duration of treatment.
Treatment Options
- Systemic corticosteroids, such as prednisone, are the first-line therapy for Sweet's syndrome, and the dose should be tailored to the individual patient's needs.
- Alternative treatments, such as colchicine or potassium iodide, may be considered for patients who cannot tolerate or have contraindications to systemic steroids.
- Topical or intralesional corticosteroids may be used for localized disease, and second-line treatments, such as dapsone or cyclosporine, may be considered for refractory cases.
Monitoring and Follow-up
- Regular monitoring for medication side effects and disease recurrence is essential during and after treatment, as Sweet's syndrome can be a recurring condition.
- The underlying condition triggering Sweet's syndrome, such as malignancy, infection, or medication reaction, must be addressed simultaneously, and the patient's response to treatment should be closely monitored.
From the Research
Treatment Options for Sweet's Syndrome
- Systemic corticosteroids are considered the 'gold standard' for the treatment of patients with Sweet's syndrome 2
- Topical and/or intralesional corticosteroids may be effective as either monotherapy or adjuvant therapy 2
- Oral therapy with either potassium iodide or colchicine typically results in rapid resolution of Sweet's syndrome symptoms and lesions 2
- Indomethacin, clofazimine, dapsone, and cyclosporine have also been effective therapeutic agents for managing Sweet's syndrome 2, 3
- Systemic antibacterials with activity against Staphylococcus aureus frequently result in partial improvement of Sweet's syndrome lesions when they are impetiginized or secondarily infected 2
Treatment of Malignancy-Associated Sweet's Syndrome
- Systemic corticosteroids are the mainstay of treatment 4
- Sweet's syndrome caused by anticancer agents sometimes involves withdrawal or temporary discontinuation of anticancer agents, use of systemic corticosteroids and/or rechallenge with either with the same anticancer agents or different agents 4
Alternative Therapies
- Traditional immunosuppressants, biologic agents, and small molecules have also been described as effective in treating Sweet's syndrome 5
- Tumor necrosis factor-alpha antagonists are becoming the preferred choice when pyoderma gangrenosum is accompanied by inflammatory bowel disease or rheumatoid arthritis 3
- Systemic retinoids (such as etretinate and acitretin) have effectively been used for treating subcorneal pustular dermatosis - either as monotherapy or in combination with dapsone or as a component of phototherapy with psoralen and UVA radiation 3