{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:18:47Z","timestamp":1790983127692,"version":"4.1.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82370588, 82570613, 92259302"],"award-info":[{"award-number":["82370588, 82570613, 92259302"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This report describes the diagnostic and therapeutic management of Sweet\u2019s syndrome (SS) presenting as a painful forehead plaque in a patient with refractory ulcerative colitis (UC) during apparent endoscopic remission. It highlights the association between active intestinal inflammation and extraintestinal manifestations (EIMs) and evaluates the efficacy of the Janus kinase (JAK) inhibitor upadacitinib after anti-TNF therapy failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A case study was conducted on a 60-year-old woman with refractory UC who presented with new-onset cutaneous lesions accompanied by fever. Diagnostic evaluation included skin biopsy histopathology, comprehensive microbiological cultures, serological testing, and sequential colonoscopies to assess UC activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Histopathology revealed a dense neutrophilic infiltrate highly suggestive of SS. Infectious etiologies were ruled out. Repeat colonoscopy revealed active colitis in the setting of newly diagnosed SS. After infliximab failure, upadacitinib 45\u202fmg\/day led to pain resolution within one week and complete plaque healing by week\u202f8, with mucosal healing and normalized inflammatory markers at follow\u2212up. Maintenance with 30\u202fmg\/day sustained remission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Active UC may drive severe neutrophilic EIMs such as SS, even when prior endoscopy suggests remission. Re-assessment of bowel disease activity is crucial in this context. Upadacitinib rapidly controlled both conditions in this anti\u2212TNF\u2212refractory case, supporting JAK inhibition for similar overlapping immune\u2212mediated presentations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1854102","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T05:40:03Z","timestamp":1785130803000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Sweet\u2019s syndrome during anti-TNF therapy with successful rescue using a JAK inhibitor in refractory ulcerative colitis: a case report and literature review"],"prefix":"10.3389","volume":"17","author":[{"given":"Yanting","family":"Shi","sequence":"first","affiliation":[{"name":"State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingbin","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Xi\u2019an No.9 Hospital","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjing","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Xijing Hospital, Fourth Military Medical University","place":["Xi\u2019an, Shannxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jindan","family":"He","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Da","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Liang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University","place":["Xi\u2019an, 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