{
  "abstract": "Necrotizing Sweet syndrome (NSS) is a rare and severe variant of Sweet syndrome characterized by erythematous and painful lesions accompanied by systemic inflammation. Because it closely mimics necrotizing soft tissue infections (NSTIs), NSS is frequently misdiagnosed, resulting in inappropriate treatment. This study reviewed published cases of NSS and characterized its demographic, clinical, and clinicopathologic features relevant to its differentiation from NSTI. For this narrative review, a literature search on PubMed (last updated June 30, 2024) identified 34 cases of NSS across 29 articles. Erythema was the most common feature (82.4%), followed by edematous plaques (41.2%). Necrosis (52.9%) and budllous lesions (38.2%), including hemorrhagic bullae, were also frequently observed, whereas pustular lesions were reported in 29.4% of cases. Multiple lesion morphologies often coexisted, highlighting the polymorphic presentation of NSS and its clinical overlap with NSTI. All patients underwent biopsy, 52.9% underwent surgical debridement, and 5.9% required amputation. Corticosteroids were the most frequently used treatment. NSS is a rare but important mimic of NSTI. Given its polymorphic presentation and overlapping cutaneous manifestations, including erythema, bullous change, and necrosis, differentiation cannot be based on clinical appearance alone and requires integration of microbiological and histopathological findings. Increased awareness of NSS is essential to avoid unnecessary surgical intervention and ensure timely, appropriate management.",
  "abstract_shown": true,
  "affiliations": [
    "Clinical Training Center, Southern TOHOKU General Hospital, Fukushima, Japan.",
    "Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.",
    "Division of General Medicine, Nerima Hikarigaoka Hospital, Tokyo, Japan.",
    "Clinical Training Center, Juntendo University Hospital, Tokyo, Japan.",
    "Clinical Training Center, Tokyo Yamate Medical Center, Tokyo, Japan.",
    "Medical School, Okayama University School of Medicine, Okayama, Japan.",
    "Clinical Training Center, Nihon University Itabashi Hospital, Tokyo, Japan.",
    "Hongo-Ochanomizu Campus Academic Media Center, Juntendo University, Tokyo, Japan.",
    "Asia University Library, Asia University, Tokyo, Japan.",
    "Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, Tokyo, Japan.",
    "Division of Medical Education, Juntendo University School of Medicine, Tokyo, Japan.",
    "Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Tochigi, Japan."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Daiki Fujita"
    },
    {
      "affs": [
        1
      ],
      "name": "Taiju Miyagami",
      "orcid": "0000-0002-4893-2224"
    },
    {
      "affs": [
        2
      ],
      "name": "Taku Harada",
      "orcid": "0000-0001-8794-6744"
    },
    {
      "affs": [
        3
      ],
      "name": "Yoshiki Tsumura"
    },
    {
      "affs": [
        4
      ],
      "name": "Ryo Hisatomi"
    },
    {
      "affs": [
        5
      ],
      "name": "Hikari Saito"
    },
    {
      "affs": [
        6
      ],
      "name": "Ryusuke Otabe"
    },
    {
      "affs": [
        7
      ],
      "name": "Naoko Mizushima",
      "orcid": "0009-0006-7206-8540"
    },
    {
      "affs": [
        7
      ],
      "name": "Yasuhiko Kiyama",
      "orcid": "0009-0000-1753-1519"
    },
    {
      "affs": [
        7,
        8
      ],
      "name": "Yuka Konishi"
    },
    {
      "affs": [
        9
      ],
      "name": "Akinori Matsuda"
    },
    {
      "affs": [
        1,
        10
      ],
      "name": "Yuji Nishizaki"
    },
    {
      "affs": [
        11
      ],
      "name": "Taro Shimizu",
      "orcid": "0000-0002-3788-487X"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2hnvcacyhznqv.bib",
  "cited_by": 0,
  "doi": "10.2147/ccid.s641833",
  "fulltext_url": "https://europepmc.org/articles/PMC13724035",
  "id": "2hnvcacyhznqv",
  "issns": [
    "1178-7015"
  ],
  "landing_url": "https://europepmc.org/article/MED/42968928",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Review"
    ],
    [
      "openalex",
      "2713|Autoimmune and Inflammatory Disorders"
    ]
  ],
  "openalex": "W7224128240",
  "pdf_url": "https://europepmc.org/articles/PMC13724035?pdf=render",
  "pmcid": "PMC13724035",
  "pmid": "42968928",
  "published": "2026-10-28",
  "publisher": "Dove Press",
  "ris": "https://research.draconitic.com/paper/2hnvcacyhznqv.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:53Z",
      "native_id": "MED:42968928",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42968928"
    },
    {
      "first_seen": "2026-11-04T12:22:34Z",
      "native_id": "PMC13724035",
      "source": "pmc",
      "url": "https://doi.org/10.2147/ccid.s641833"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Autoimmune and Inflammatory Disorders",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Necrotizing Sweet Syndrome as a Mimic of Necrotizing Soft Tissue Infection: A Narrative Review.",
  "title_text": "Necrotizing Sweet Syndrome as a Mimic of Necrotizing Soft Tissue Infection: A Narrative Review.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:45Z",
  "url": "https://research.draconitic.com/paper/2hnvcacyhznqv",
  "venue": "Clinical, cosmetic and investigational dermatology",
  "versions": []
}