{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:58:41Z","timestamp":1789055921069,"version":"build-2803163510"},"reference-count":9,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T00:00:00Z","timestamp":1688428800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T00:00:00Z","timestamp":1688428800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Azathioprine hypersensitivity can occasionally present as Sweet\u2010like syndrome, a dose\u2010independent side effect characterized by the unanticipated onset of macules, papules, and pustules.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 35\u2010year\u2010old woman with systemic lupus erythematosus presented with complaints of generalized maculopapular rash, facial swelling, and bilateral lower extremity edema with a duration of 4\u2009days and a 2\u2010day history of constitutional symptoms within 2\u2009weeks of the beginning of azathioprine therapy to treat existing lupus nephritis (class 2\/3).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Patients who experience azathioprine hypersensitivity syndrome can present with erythema nodosum, small\u2010vessel vasculitis, acute generalized exanthematous pustulosis, Sweet syndrome, and nonspecific dermatosis. The following signs and symptoms are used as criteria to diagnose drug\u2010induced Sweet syndrome: (a) abrupt onset of painful erythematous plaques, (b) histopathological evidence of dense neutrophilic infiltrate without evidence of leukocytoclastic vasculitis, (c) temperature higher than 39.7\u00b0C, (d) temporal relationship between drug ingestion and clinical presentation, and (e) temporal resolution of lesions after drug withdrawal. Our patient met three out of five criteria and was diagnosed with Sweet\u2010like syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our case highlights the uncommonly presented azathioprine\u2010induced Sweet\u2010like syndrome that occurs abruptly after the commencement of the offending drug. This diagnosis can be established through basic laboratory workup and skin biopsy findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1756-185x.14817","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T08:25:45Z","timestamp":1688459145000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Azathioprine hypersensitivity: A\n                    <scp>Sweet\u2010like<\/scp>\n                    syndrome"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7831-4822","authenticated-orcid":false,"given":"Lokesh Koumar","family":"Sivanandam","sequence":"first","affiliation":[{"name":"Sri Lakshmi Narayana Institute of Medical Sciences  Puducherry India"},{"name":"Team Erevnites  Trivandrum 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