# A Case of Sweet Syndrome Complicating Ulcerative Colitis Treated With Upadacitinib

## TL;DR

A 24-year-old man with ulcerative colitis developed Sweet syndrome, a rare skin condition, and was successfully treated with upadacitinib after other treatments failed.

## Contribution

First documented case of Sweet syndrome treated with upadacitinib in a patient with ulcerative colitis.

## Key findings

- Sweet syndrome can complicate ulcerative colitis and present with atypical skin manifestations.
- Upadacitinib was effective in treating Sweet syndrome after steroids and biologics failed.
- This case emphasizes the need to consider Sweet syndrome in ulcerative colitis patients with skin symptoms.

## Abstract

Sweet syndrome, also known as acute febrile neutrophilic dermatosis, is a rare inflammatory skin condition characterized by the sudden onset of painful, erythematous papules and plaques. It has been associated with underlying inflammatory bowel disease. We present a 24-year-old man with recently diagnosed ulcerative colitis on infliximab and methotrexate who was diagnosed by biopsy with Sweet syndrome. The patient was treated with multiple trials of steroids and biologics until finally showing improvement with upadacitinib. This case highlights the importance of considering Sweet syndrome in ulcerative colitis patients with atypical skin manifestations and the first documented case of Sweet syndrome treated with upadacitinib.