Sweet syndrome (SS) is a rare inflammatory skin condition characterized by painful erythematous plaques or nodules with predominantly neutrophilic infiltrates in the dermis and is associated with various infections, hematological malignant neoplasms, and autoimmune disorders.¹ Most patients respond well to systemic corticosteroids. This case report describes a patient with SS whose condition improved with spesolimab after failure of high-dose corticosteroids.

A man in his 40s presented with a 3-month history of painful erythematous papules and plaques and a 6-year history of mild pancytopenia not requiring treatment. Physical examination showed erythematous, edematous, tender papules, plaques, and crusts on his face, neck, back, arms, and hands. Some lesions appeared targetoid, while others resembled bulla (Figure 1A and B).