Successful use of baricitinib in the treatment of refractory rheumatoid arthritis-associated Sweet syndrome.

A 59-year-old Hispanic woman on prednisone, golimumab, and leflunomide for her partially-controlled chronic rheumatoid factor positive rheumatoid arthritis (RA) presented with a 10-month history of a mildly painful eruption on her mid-chest, which consisted of non-scaly, erythematous and edematous papules and plaques with areas of annular and polycyclic configuration (Figure 1a). The patient reported malaise, low-grade fever, polyarthralgia, and small joint stiffness that lasted up to 3 hours. Laboratory tests revealed mild leukocytosis, with an elevated erythrocyte sedimentation rate and C-reactive protein.