In the world of medicine, most inhalers are seen as safe, life-improving tools — especially for patients managing chronic conditions like COPD or asthma. But in a rare and eye-opening case, a routine medication switch led not to better breathing… but to a sudden, painful skin crisis.
Meet the first documented case where an inhaled medication triggered Sweet syndrome — a rare immune-mediated disorder that mimics infection but hides behind bright red, tender rashes and fever.
This isn’t just a medical curiosity.
It’s a critical reminder: even common treatments can carry hidden risks.
🧪 The Case: From Inhaler Change to Medical Mystery
Patient:
55-year-old woman
History of hypertension and COPD
Stable on medications (enalapril + formoterol) for years
The Change:
Due to declining lung function, her pulmonologist switched her to a new dual-action inhaler:
➡️ Indacaterol/glycopyrronium (a long-acting bronchodilator combo)
48 Hours Later:
She developed:
🔥 Painful, bright red plaques on face and neck
🌡️ Low-grade fever (37.9°C / 100.2°F)
No signs of infection, allergy, or sunburn (despite recent protected sun exposure)
No new skincare products. No illness. Just… the new inhaler.
Urgently referred to dermatology.
🧫 Diagnosis: Sweet Syndrome (Acute Febrile Neutrophilic Dermatosis)
