A Sweet Diagnosis for a Non-Resolving Rash

Subcutaneous Sweet’s syndrome (SSS) is a rare variant of Sweet’s syndrome (SS), clinically characterized by erythematous plaques or nodules with a histologic pattern demonstrating a neutrophilic panniculitis (NP). We report a case of a 74-year-old woman with myelodysplastic syndrome (MDS) who presented with persistent fever, malaise, and non-resolving generalized erythematous nodules and was found to have an MDS-related SSS. SSS should be entertained and other causes of NP should be excluded prior to treating a patient with systemic corticosteroids. Early diagnosis of SSS in a patient not responding to broad-spectrum antibiotics is crucial as it helps to minimize unnecessary prolonged antibiotics exposure in this era of antimicrobial resistance. In patients with frequent relapses, a slow corticosteroid taper could be beneficial.