Sweet Syndrome and Secondary Syphilis in a Person with Acute Necrotizing Tonsillitis

Joseph Mishal, Igor Viner, Alexandro Livoff, Shlomo Maayan, Eli Magen

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3 Scopus citations


Syphilis has received its classical designation as one of "the great imitators,"reflecting a wide variety of symptoms and presentations, which can cause difficulties in diagnosis. Here we report an unusual case of secondary syphilis in a person with acute necrotizing tonsillitis and Sweet syndrome. A 33-year-old female presented with fever, bilateral cervical lymphadenopathy, tonsillar enlargements with ulcerated pus-filled lesions on the right tonsil, and multiple pseudovesicular, mammillated, edematous plaques on her neck, face, and extremities. Syphilis serology was positive and a skin biopsy demonstrated a neutrophil-rich dermatitis characteristic of Sweet syndrome. The association of Treponema pallidum infection with Sweet syndrome may be a coincidence; nevertheless, our case serves as a reminder that secondary syphilis should remain in the differential diagnosis of the acute febrile neutrophilic dermatosis.

Original languageEnglish
Pages (from-to)216-221
Number of pages6
JournalCase Reports in Dermatology
Issue number1
StatePublished - Jan 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2021


  • Secondary syphilis
  • Sweet syndrome
  • Tonsillitis


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