Pregnancy-associated Sweet’s syndrome

Links checked on 30/03/17.

Can Sweet’s syndrome be triggered by pregnancy?

Yes, but it’s rare. Only about 2% of cases of Sweet’s syndrome are associated with pregnancy (Chebbi and Josephine, 2014).

How many cases have been reported?

By the end of 2014, there had been at least 10 cases of pregnancy-associated Sweet’s syndrome reported in literature (Chebbi and Josephine, 2014; Serrano-Falcón and Serrano-Falcón, 2010: 559). However, it is possibly being under-reported and underdiagnosed due to:

  • A lack of awareness and knowledge of pregnancy-associated Sweet’s syndrome.
  • The variability of Sweet’s syndrome symptoms, and on rare occasions, skin lesions not being present. This means that a diagnosis of Sweet’s syndrome may be not be considered or dismissed.
  • Pregnancy affecting blood results (Serrano-Falcón and Serrano-Falcón, 2010: 559). This means that the blood results of someone with pregnancy-associated Sweet’s syndrome might show something different from what you would expect to find.

Can pregnancy-associated Sweet’s syndrome be confused with other skin conditions?

Yes. It may be confused with urticarial vasculitis, eosinophilic panniculitis, and herpes gestationis (Serrano-Falcón and Serrano-Falcón, 2010: 558).

What causes pregnancy-associated Sweet’s syndrome?

We are not entirely sure what causes pregnancy-associated Sweet’s syndrome in some women, but it may be linked to hormonal changes and increased progesterone or oestrogen levels (Serrano-Falcón and Serrano-Falcón, 2010: 558).

What are the symptoms of pregnancy-associated Sweet’s syndrome?

Read about the symptoms of Sweet’s syndrome here.

How  is it diagnosed?

Read about how Sweet’s syndrome is diagnosed here.

How is pregnancy-associated Sweet’s syndrome treated?

  • Systemic corticosteroids (steroids) such as Prednisone are the main form of treatment. Treatment should start with 1mg/kg/day or less, in a single dose taken in the morning, and should be tapered off until the minimum effective dose is determined (Serrano-Falcón and Serrano-Falcón, 2010:559).
  • Steroid creams can be used if the skin lesions are small and in one area, and if there are few other symptoms.
  • Other treatment options to be considered include colchicine and indomethacin.

Are there treatments that should be avoided?

Yes. Certain medications that are sometimes used to treat Sweet’s syndrome are not safe to use during pregnancy. These include:

  • Potassium iodide.
  • Immunosuppressants such as ciclosporin, azathioprine, and methotrexate.
  • Biologics such as infliximab, adalimumab, and etanercept.

Does Sweet’s syndrome cause complications or affect how you will be cared for during pregnancy?

Sweet’s syndrome does not tend to cause complications during pregnancy or affect the baby. However, as a precaution, your doctor or nurse will need to monitor you as for an at-risk pregnancy.

Can pregnancy-associated Sweet’s syndrome come back once it has been treated?

Pregnancy-associated Sweet’s syndrome normally settles after treatment. This may take up to 7 days, weeks or months. Sometimes, the Sweet’s syndrome doesn’t completely settle until delivery of the baby, and may flare-up again with later pregnancies (Chebbi and Josephine, 2014).

N.B. There are some cases of pregnancy-associated Sweet’s syndrome that have not resolved after delivery, but have not been reported in literature. However, this may be for reasons such as infection, underlying illness, or medication.

References.

Chebbi, W. and Josephine M. (2014) Sweet syndrome during pregnancy: a rare entity not to ignore. The Pan African Medical Journal, 18: 185 (online). Article in French. Use translate.

Serrano-Falcón, C. and Serrano-Falcón, M. (2010) Sweet’s syndrome in a pregnant women. Actas Dermo-Sifiliograficas, Jul;101(6):558-9 (online).

Further information.

Giovanna Brunasso, A. and Massone, C. (2008) Clinical images. Sweet syndrome during pregnancy. CMAJ: Canadian Medical Association Journal, Oct 21;179(9):967 (online).

© 2012-2017 Sweet’s Syndrome UK

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