Clinical Rheumatology

, Volume 37, Issue 8, pp 2281–2284 | Cite as

Systemic sclerosis-rheumatoid arthritis overlap syndrome complicated with Sweet’s syndrome

  • T. Zhu
  • W. L. Zhao
  • Y. P. Zeng
  • Y. H. Liu
  • H. Z. Jin
  • L. LiEmail author
Brief Report


Herein, we report a case of a 34-year-old woman with systemic sclerosis (SSc)-rheumatoid arthritis (RA) overlap syndrome (OS) complicated with Sweet’s syndrome. OS has been defined as entities satisfying classification criteria of at least two connective tissue diseases (CTD) occurring at the same or at different times in the same patient. The CTD include RA, SSc, systemic lupus erythematosus (SLE), polymyositis, and dermatomyositis. Sweet’s syndrome also known as acute febrile neutrophilic dermatosis was first described by Robert Sweet in 1964. Sweet’s syndrome is characterized by fever, neutrophilia, erythematous skin lesions, and a diffuse dermal infiltrate of mature neutrophils. There are sets of associations that we will discuss in this article between OS and Sweet’s syndrome.


Overlap syndrome Rheumatoid arthritis Sweet’s syndrome Systemic sclerosis 

Abbreviation and acronym


American College of Rheumatology


connective tissue diseases


neutrophilic dermatoses


overlap syndrome


rheumatoid arthritis


systemic lupus erythematosus


systemic sclerosis


Funding information

This study was supported by the National Natural Science Foundation of China (81371731). Milstein Medical Asian American Partnership Foundation (2017, Dermatology), and Education Reform Projects of Peking Union Medical College (No. 2016zlgc0106).

Compliance with ethical standards



Supplementary material

10067_2018_4150_MOESM1_ESM.xlsx (10 kb)
ESM 1 (XLSX 9.59 kb)


  1. 1.
    van den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M et al (2013) 2013 classification criteria for systemic sclerosis: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis Rheum 65(11):2737–2747. CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO III, Birnbaum NS, Burmester GR, Bykerk VP, Cohen MD, Combe B, Costenbader KH, Dougados M, Emery P, Ferraccioli G, Hazes JMW, Hobbs K, Huizinga TWJ, Kavanaugh A, Kay J, Kvien TK, Laing T, Mease P, Ménard HA, Moreland LW, Naden RL, Pincus T, Smolen JS, Stanislawska-Biernat E, Symmons D, Tak PP, Upchurch KS, Vencovský J, Wolfe F, Hawker G (2010) 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 62(9):2569–2581. CrossRefPubMedGoogle Scholar
  3. 3.
    Horimoto AMC, da Costa IP (2015) Overlap between systemic sclerosis and rheumatoid arthritis: a distinct clinical entity? Rev Bras Reumatol 56:1–12. CrossRefGoogle Scholar
  4. 4.
    Szücs G, Szekanecz Z, Zilahi E et al (2007) Systemic sclerosis-rheumatoid arthritis overlap syndrome: a unique combination of features suggests a distinct genetic, serological and clinical entity. Rheumatology 46:989–993. CrossRefPubMedGoogle Scholar
  5. 5.
    Rochet NM, Chavan RN, Cappel MA, Wada DA, Gibson LE (2013) Sweet syndrome: clinical presentation, associations, and response to treatment in 77 patients. J Am Acad Dermatol 69(4):557–564. CrossRefPubMedGoogle Scholar
  6. 6.
    White JM, Mufti GJ, Salisbury JR, du Vivier AW (2006) Cutaneous manifestations of granulocyte colony-stimulating factor. Clin Exp Dermatol 31(2):206–207. CrossRefPubMedGoogle Scholar
  7. 7.
    Roujeau JC (2000) Neutrophilic drug eruptions. Clin Dermatol 18(3):331–337. CrossRefPubMedGoogle Scholar
  8. 8.
    Denise C, Walker MD, Cohen PR, Houston T (1996) Trimethoprim-sulfamethoxazole-associated acute febrile neutrophilic dermatosis: case report and review of drug-induced Sweet’s syndrome. J Am Acad Dermatol 34:918–923CrossRefGoogle Scholar
  9. 9.
    Zhang KJ, Zhou GZ, Yu CP et al (2016) Pustular rheumatoid neutrophilic dermatitis with Koebner phenomenon. Indian J Dermatol Venereol Leprol 82(5):569–571. CrossRefPubMedGoogle Scholar
  10. 10.
    Saeb-Lima M, Charli-Joseph Y, Rodríguez-Acosta ED, Domínguez-Cherit J (2013) Autoimmunity-related neutrophilic dermatosis: a newly described entity that is not exclusive of systemic lupus erythematosus. Am J Dermatopathol 35(6):655–660. CrossRefPubMedGoogle Scholar
  11. 11.
    Hau E, Vignon Pennamen MD, Battistella M, Saussine A, Bergis M, Cavelier-Balloy B, Janier M, Cordoliani F, Bagot M, Rybojad M, Bouaziz JD (2014) Neutrophilic skin lesions in autoimmune connective tissue diseases: nine cases and a literature review. Medicine (Baltimore) 93(29):e346. CrossRefGoogle Scholar
  12. 12.
    Németh T, Mócsai A (2012) The role of neutrophils in autoimmune diseases. Immunol Lett 143:9–19. CrossRefPubMedGoogle Scholar

Copyright information

© International League of Associations for Rheumatology (ILAR) 2018

Authors and Affiliations

  • T. Zhu
    • 1
  • W. L. Zhao
    • 1
  • Y. P. Zeng
    • 1
  • Y. H. Liu
    • 1
  • H. Z. Jin
    • 1
  • L. Li
    • 1
    Email author
  1. 1.Department of Dermatology, Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

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