**Question:** Treatment of choice of sweet syndrome is

A. Cyclosporine
B. Dapsone
C. Prednisolone
D. Topical corticosteroids

**Core Concept:** Sweet's syndrome, also known as acute febrile neutrophilic dermatosis, is a dermatological condition characterized by sudden onset of painful, tender, erythematous plaques and nodules. The condition is typically associated with systemic inflammatory disorders such as malignancy, infections, and autoimmune diseases.

**Why the Correct Answer is Right:** Dapsone (an antibiotic and immunosuppressive agent) is the treatment of choice for Sweet's syndrome due to its anti-inflammatory and immunosuppressive properties. Dapsone inhibits the production of cytokines and neutrophil chemotaxis, suppressing inflammation and reducing neutrophil infiltration into the skin, leading to improvement in the lesions.

**Why Each Wrong Option is Incorrect:**

A. Cyclosporine: While cyclosporine has immunomodulatory and anti-inflammatory effects, it is generally not the first-line treatment for Sweet's syndrome as it has more off-target side effects and requires close monitoring of blood levels.

B. Topical corticosteroids: Topical corticosteroids are not effective in treating Sweet's syndrome as the condition involves systemic inflammation and requires systemic therapy.

C. Prednisolone: Prednisolone is a systemic corticosteroid with anti-inflammatory effects, but dapsone is generally preferred due to its targeted immunosuppressive action and fewer side effects.

**Clinical Pearl:** Sweet's syndrome is typically associated with underlying systemic illnesses and should be managed accordingly. It is essential to differentiate between Sweet's syndrome and other neutrophilic dermatoses, such as pyoderma gangrenosum, for appropriate management.

In conclusion, dapsone is the first-line treatment for Sweet's syndrome due to its anti-inflammatory and immunosuppressive properties. Close monitoring of blood levels is necessary when using cyclosporine, and topical corticosteroids are not effective for systemic skin conditions. Prednisolone can be considered when dapsone is not available or contraindicated, but dapsone is generally preferred due to its targeted immunosuppressive action and fewer side effects.