Sweet Syndrome Secondary to Inflammatory Bowel Disease

1Department of Gastroenterology; 2Department of Pathology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario Correspondence: Dr Malcolm M Wells, Schulich School of Medicine, University of Western Ontario, Room M106, Medical Science Building, London, Ontario N6A 5C1. Telephone 519-685-8500, e-mail malcolm.wells@gmail.com Received for publication September 20, 2012. Accepted October 2, 2012 CASE PRESENTATION A 64-year-old man presented to hospital with a three-month history of progressively worsening mucousy bloody diarrhea, polyarthritis and a rash covering his lateral malleolus. His history was significant for previous quadriceps tendon rupture and supraventricular tachycardia. His only medication was a short course of prednisone initiated shortly before his hospitalization. He was a nonsmoker and nondrinker, with no significant family history. Physical examination was significant for a fever of 38.2°C as well as a warm swollen left knee, ankle and foot. A bullous lesion 5 cm in size was present on the medial aspect of the left malleolus (Figure 1), with an erythematous base and draining serosanginous fluid. He exhibited multiple oral ulcers. The remainder of the examination was noncontributory. Laboratory investigations revealed neutrophilia (14.5×109/L) and a normocytic anemia (1×105 g/L). Stool was negative for ova and parasites, and cell culture was negative for Clostridium difficile.