Sweet’s syndrome during anti-TNF therapy with successful rescue using a JAK inhibitor in refractory ulcerative colitis: a case report and literature review

What To Know

This article reports a single-patient case where Sweet’s syndrome (a neutrophilic skin condition) occurred alongside active UC and improved after switching from infliximab to upadacitinib. The diagnosis relied on skin biopsy and exclusion of infection; repeated colonoscopy documented intestinal inflammation that appeared linked to the skin manifestation.

The key clinical point is that new severe skin EIMs can signal ongoing intestinal disease even if earlier endoscopy suggested remission, so re-evaluation of bowel activity is important.

In this case, upadacitinib was used as rescue therapy after anti‑TNF failure and the patient experienced rapid clinical and endoscopic improvement, but this is a single case report—not proof of general effectiveness.

If clinicians consider JAK inhibition in similar scenarios, they should weigh individual patient factors, prior biologic exposure, and known risks of JAK inhibitors; treatment decisions should follow clinical guidelines and specialist judgment.