Oral Sweet's syndrome occurring in ulcerative colitis

BMJ Case Rep. 2017 Mar 15:2017:bcr2016218249. doi: 10.1136/bcr-2016-218249.

Abstract

A man aged 78 years presented with a 3-week history of tender mouth ulceration associated with arthralgia and weight loss. He had ulcerative colitis that was diagnosed 10 years previously which was well controlled on adalimumab 40 mg fortnightly. Biochemical and haematological investigations showed raised inflammatory markers (CRP 105) and a marked neutrophilia (10). On examination, the patient had severe oral ulceration involving the anterior tongue and lips. In addition, on cutaneous examination had tender erythematous nodules involving the forehead. Histology from a diagnostic punch biopsy showed marked dermal oedema with an inflammatory infiltrate consisting of neutrophils. Our working diagnosis was therefore oral Sweet's syndrome. The patient was then started on oral prednisolone and later received colchicine which led to a complete resolution of symptoms.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Colchicine / therapeutic use
  • Colitis, Ulcerative / complications*
  • Colitis, Ulcerative / drug therapy
  • Humans
  • Male
  • Oral Ulcer / drug therapy
  • Oral Ulcer / etiology
  • Oral Ulcer / pathology*
  • Prednisolone / therapeutic use
  • Sweet Syndrome / drug therapy
  • Sweet Syndrome / etiology
  • Sweet Syndrome / pathology*
  • Treatment Outcome

Substances

  • Prednisolone
  • Colchicine