Medication adjustments are common in patients with chronic illnesses, but sometimes even minor changes can trigger serious complications. A 55-year-old woman with COPD and hypertension experienced this firsthand when her inhaler was switched to a new combination therapy.
For two days, she felt hopeful. Then painful red patches appeared across her face and neck, accompanied by a low-grade fever and burning discomfort. She had not changed soaps, lotions, or detergents—the only new factor was the inhaler.
Concerned, she sought help from her primary care provider, who promptly referred her to a dermatologist. Examination revealed tender, erythematous plaques that did not match typical eczema or dermatitis. The timing suggested a drug-induced reaction, prompting a biopsy and blood tests while the inhaler was immediately discontinued.
Within 48 hours of starting oral corticosteroids, her symptoms began to improve. The rapid response indicated an inflammatory reaction rather than an infection, pointing toward a rare condition: Sweet syndrome, also known as acute febrile neutrophilic dermatosis.
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