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Submitted: 2022-10-29
DOI: 10.35119/myjo.v7i1.324
Case Reports
Published: 2025-01-27

Is this too sweet? Orbital infiltration as the only sign of Sweet syndrome relapse

Universiti Malaya Eye Research Centre, Department of Ophthalmology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
Universiti Malaya Eye Research Centre, Department of Ophthalmology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
Universiti Malaya Eye Research Centre, Department of Ophthalmology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
acute febrile neutrophilic dermatosis extraocular muscles ocular involvement Sweet syndrome systemic inflammation

Abstract

Background: Sweet syndrome (acute febrile neutrophilic dermatosis) is a rare dermatologic disorder with accompanying features of systemic inflammation. Ocular presentations of Sweet syndrome vary, including periorbital/orbital inflammation, dacryoadenitis, conjunctivitis, episcleritis, limbal nodules, iritis, peripheral ulcerative keratitis, and choroiditis.

Case presentation: We present a case of a relapsed Sweet syndrome manifesting only with ocular features of extraocular muscle infiltration. The patient presented only with limited extraocular movement, resulting in diplopia. He responded well to oral steroids and fully recovered after 3 months.

Conclusion: Ocular manifestation could be the only presenting sign of Sweet syndrome relapse even in the absence of other systemic manifestations and negative laboratory investigations. Therefore, a high index of clinical suspicion is necessary in order to initiate early and appropriate treatment.