Abstract
We report the case of a 37 year-old man who developed Sweet's syndrome while receiving Highly Active Anti-Retroviral Therapy (HAART) for the treatment of HIV infectious disease. HAART was initially begun seven years ago, but was terminated for a period due to side-effects, then restarted 1 year and 4 months prior to consultation. Three months after the therapy was restarted, the patient developed a rash with fever, a feature that was similar to the presented episode; this first episode improved without any treatment. One week prior to his first visit to our outpatient clinic, the patient developed erythema with tenderness on the left side of his neck, a fever of 40°C, and arthralgia of the right knee and ankle. A physical examination revealed two erythematous plaques with raised peripheries on the left side of the neck. Blood examination showed a leukocyte count of 10800/μl, and neutrophils at 79.8%, CRP 13.4mg/dl. Histopathological examination revealed intense infiltration mainly of neutrophils with leukocytoclasis and lymphocytes in the dermis. After oral administration of prednisolone 20mg/day, the erythema and arthralgia disappeared with no recurrence. In our case, Sweet's syndrome developed twice during the administration of HAART. We speculate that the onset of Sweet's syndrome may be related to an increase in the number of CD4+ lymphocytes caused by HAART. This is the first report in Japan of Sweet's syndrome with HIV infectious disease.
