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infiltrate of the papillary dermis without leukocytoklastic vasculitis, compatible with the diagnosis of Sweet’s syndrome. She was treated with systemic steroids with rapid symptomatic improvement. The steroid dose was gradually tapered. Her medical history was significant for anemia for 7 years, worsening in conjunction with any concomitant disease, and occasionally requiring blood transfusions. Based on clinical features and bone marrow aspiration, hematologic work up suggested the diagnosis of congenital dyserythropoietic anemia. The patient developed diffuse abdominal pain the day following her admission. Abdominal CT scan indicated severe pancolitis and free fluid within the abdominal cavity. Conservative treatment with broadspectrum antibiotics, intravenous hydration, and bowel rest was initiated. However, within 48 h she developed worsening abdominal pain, signs of peritoneal irritation, tachypnea, and tachycardia. The patient was taken to the operating room emergently and the entire colon was found to be severely inflamed and thickened with 2 microperforations. The small bowel appeared normal throughout its length. Total abdominal colectomy with Hartmann’s pouch, which was closed at the upper rectum, and an ileostomy were performed. Dear Sir, Sweet’s syndrome is a rare autoimmune condition which manifests as red or brown painful skin lesions, most commonly in the upper extremities, face and neck. The mainstay of treatment involves high doses of systemic steroids, usually resulting in rapid resolution of symptoms [1] . Rare cases of Crohn’s disease and ulcerative colitis associated with Sweet’s syndrome have been reported in the literature [2] . This letter reports a nontypical presentation of inflammatory bowel disease (IBD), most probably ulcerative colitis, wherein Sweet’s syndrome as well as severe anemia preceded an unusual intestinal manifestation of IBD.

Sweet’s Syndrome in Association with Ulcerative Colitis and Dyserythropoietic Anemia