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Table 1 Diagnostic criteria for classical Sweet's syndrome versus drug-induced Sweet's syndrome

From: Sweet's syndrome – a comprehensive review of an acute febrile neutrophilic dermatosis

Classicala Drug-inducedb
(1) Abrupt onset of painful erythematous plaques or nodules (A) Abrupt onset of painful erythematous plaques or nodules
(2) Histopathologic evidence of a dense neutrophilic infiltrate without evidence of leukocytoclastic vasculitis (B) Histopathologic evidence of a dense neutrophilic infiltrate without evidence of leukocytoclastic vasculitis
(3) Pyrexia >38°C (C) Pyrexia >38°C
(4) Association with an underlying hematologic or visceral malignancy, inflammatory disease, or pregnancy, OR preceded by an upper respiratory or gastrointestinal infection or vaccination (D) Temporal relationship between drug ingestion and clinical presentation, OR temporally-related recurrence after oral challenge
(5) Excellent response to treatment with systemic corticosteroids or potassium iodide (E) Temporally-related resolution of lesions after drug withdrawal or treatment with systemic corticosteroids
(6) Abnormal laboratory values at presentation (three of four): erythrocyte sedimentation rate >20 mm/hr; positive C-reactive protein; >8,000 leukocytes; >70% neutrophils  
  1. aThe presence of both major criteria (1 and 2), and two of the four minor criteria (3, 4, 5, and 6) is required in order to establish the diagnosis of classical Sweet's syndrome; the patients with malignancy-associated Sweet's syndrome are included with the patients with classical Sweet's syndrome in this list of diagnostic criteria.
  2. bAll five criteria (A, B, C, D, and E) are required for the diagnosis of drug-induced Sweet's syndrome.
  3. Source [13]: Adapted with permission from Walker DC, Cohen PR: Trimethoprim-sulfamethoxazole-associated acute febrile neutrophilic dermatosis: case report and review of drug induced Sweet's syndrome. J Am Acad Dermatol 1996;34:918–923. Copyright 1996, Reprinted with permission from the American Academy of Dermatology, Inc., Elsevier Ltd, Oxford, United Kingdom.