Acute Febrile Neutrophilic Dermatosis (Sweet Syndrome) Medication

Updated: Jun 02, 2020
  • Author: Yoon-Soo (Cindy) Bae, MD; Chief Editor: William D James, MD  more...
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Medication

Medication Summary

The goals of pharmacotherapy in Sweet syndrome (acute febrile neutrophilic dermatosis) are to reduce morbidity and to prevent complications. The best-documented first-line options are systemic corticosteroids or topical steroids if the lesions are limited. If the use of corticosteroids is contraindicated, anti-inflammatories such as dapsone or colchicine can be used as alternative first-line agents.

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Corticosteroids

Class Summary

Corticosteroids have anti-inflammatory properties and cause profound and varied metabolic effects. In addition, these agents modify the body's immune response to diverse stimuli.

Prednisone (Deltasone)

Prednisone is useful in acute neutrophilic dermatitis because of its anti-inflammatory properties. It must be metabolized to the active metabolite prednisolone for effect. Conversion may be impaired in those with liver disease.

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Anti-inflammatories

Class Summary

These agents modulate events leading to inflammatory reactions.

Dapsone (Avlosulfon)

Dapsone is bactericidal and bacteriostatic against mycobacteria; its mechanism of action is similar to that of sulfonamides for which competitive antagonists of PABA prevent formation of folic acid, inhibiting bacterial growth.

Colchicine

Colchicine decreases leukocyte motility and phagocytosis in inflammatory responses. It has effects against neutrophils, which are probably involved in the expression of cutaneous vasculitis; it has been demonstrated to be steroid sparing in open-label studies. The only double-blinded placebo-controlled trial failed to demonstrate its efficacy; however, several methodological errors occurred in this study. It is not FDA approved in children.

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