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Within 48 hours of stopping the medication and beginning corticosteroids, her symptoms improved significantly. Fever resolved, pain lessened, and the red plaques began to fade—strongly suggesting a drug-induced inflammatory reaction.

A skin biopsy confirmed the diagnosis: dense neutrophilic infiltration in the dermis without vasculitis, consistent with Sweet syndrome (acute febrile neutrophilic dermatosis).

Sweet syndrome is a rare inflammatory condition characterized by sudden, painful red or purple plaques, often with fever and elevated white blood cells. Its exact mechanism is unclear but likely involves immune dysregulation and abnormal neutrophil activation. Known triggers include infections, malignancies (especially hematologic cancers), autoimmune disorders, pregnancy, and certain medications.

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