INDOMETHACIN TREATMENT OF 18 PATIENTS WITH SWEETS-SYNDROME

Background: The standard treatment for Sweet's syndrome (acute febrile neutrophilic dermatosis) is oral corticosteroids. Despite a good init ial response, the disease is characterized by frequent relapses. Objec tive: Our purpose was to test the therapeutic effect of the nonsteroid al antiinflammatory drug indomethacin on Sweet's syndrome. Methods: Al l patients with Sweet's syndrome observed during a 4-year period were given indomethacin, 150 mg/day for the first week and 100 mg/day for t wo additional weeks. The therapeutic response was assessed on days 4, 7, 14, 30, and 180. Results: Seventeen of 18 patients had a good initi al response; fever and arthralgias were markedly attenuated within 48 hours and eruptions cleared between 7 and 14 days. The remaining patie nt's cutaneous lesions continued to develop and were successfully trea ted with prednisone (1 mg/kg/day). The only side effect of indomethaci n treatment was epigastric pain in two patients. No patient had a rela pse after discontinuation of indomethacin (mean followup, 20.1 months) . Conclusion: Indomethacin is a safe and effective treatment for Sweet 's syndrome.