Rheumatoid neutrophilic dermatitis

Rheumatoid neutrophilic dermatitis occurs more frequently in patients with severe, persistent seropositive arthritis; it presents clinically as erythematous papules, nodules, plaques, or lesions resembling urticaria without any accompanying symptoms.{{cite journal | last1=Xue | first1=Yun | last2=Cohen | first2=Jeffrey M. | last3=Wright | first3=Natalie A. | last4=Merola | first4=Joseph F. | title=Skin Signs of Rheumatoid Arthritis and its Therapy-Induced Cutaneous Side Effects | journal=American Journal of Clinical Dermatology | publisher=Springer Science and Business Media LLC | volume=17 | issue=2 | date=December 9, 2015 | issn=1175-0561 | doi=10.1007/s40257-015-0167-z | pages=147–162| pmid=26649439 | s2cid=42706531 }}{{cite journal | last1=Ziemer | first1=Mirjana | last2=Müller | first2=Anne-Katrin | last3=Hein | first3=Gert | last4=Oelzner | first4=Peter | last5=Elsner | first5=Peter | title=Incidence and classification of cutaneous manifestations in rheumatoid arthritis | journal=JDDG: Journal der Deutschen Dermatologischen Gesellschaft | publisher=Wiley | volume=14 | issue=12 | date=November 25, 2016 | issn=1610-0379 | doi=10.1111/ddg.12680 | pages=1237–1246| pmid=27886444 | s2cid=3424646 }}{{cite journal | last1=Hata | first1=Tissa | last2=Kavanaugh | first2=Arthur | title=Rheumatoid arthritis in dermatology | journal=Clinics in Dermatology | publisher=Elsevier BV | volume=24 | issue=5 | year=2006 | issn=0738-081X | doi=10.1016/j.clindermatol.2006.07.008 | pages=430–437| pmid=16966022 }} Less common conditions include annular lesions, blisters, ulcers, and vesicles.{{cite journal | last1=Fujio | first1=Yumi | last2=Funakoshi | first2=Takeru | last3=Nakayama | first3=Kaori | last4=Amagai | first4=Masayuki | last5=Ohyama | first5=Manabu | title=Rheumatoid neutrophilic dermatosis with tense blister formation: A case report and review of the literature | journal=Australasian Journal of Dermatology | publisher=Wiley | volume=55 | issue=1 | date=October 25, 2012 | issn=0004-8380 | doi=10.1111/j.1440-0960.2012.00963.x | pages=e12–e14| pmid=23094684 | s2cid=39668337 }}{{cite journal | last1=Filosa | first1=Alessandra | last2=Filosa | first2=Giorgio | title=Neutrophilic dermatoses: a broad spectrum of disease | journal=Italian Journal of Dermatology and Venereology | publisher=Edizioni Minerva Medica | volume=153 | issue=2 | year=2018 | pages=265–272 | issn=2784-8671 | doi=10.23736/s0392-0488.18.05841-8 | pmid=29368857 }} Skin lesions are typically symmetrical, but they can occasionally be distributed asymmetrically.{{cite journal | last1=Brown | first1=Timothy S. | last2=Fearneyhough | first2=Paul K. | last3=Burruss | first3=Jyoti B. | last4=Callen | first4=Jeffrey P. | title=Rheumatoid neutrophilic dermatitis in a woman with seronegative rheumatoid arthritis | journal=Journal of the American Academy of Dermatology | publisher=Elsevier BV | volume=45 | issue=4 | year=2001 | issn=0190-9622 | doi=10.1067/mjd.2001.119031 | pages=596–600| pmid=11568753 }}{{cite journal | last1=Chua-Aguilera | first1=Carolyn Jean | last2=Möller | first2=Burkhard | last3=Yawalkar | first3=Nikhil | title=Skin Manifestations of Rheumatoid Arthritis, Juvenile Idiopathic Arthritis, and Spondyloarthritides | journal=Clinical Reviews in Allergy & Immunology | publisher=Springer Science and Business Media LLC | volume=53 | issue=3 | date=July 27, 2017 | issn=1080-0549 | doi=10.1007/s12016-017-8632-5 | pages=371–393| pmid=28752373 | s2cid=43240243 }} Dorsal surfaces of hands and arms are preferred sites, with an emphasis on the extensor surfaces of extremities and joints.{{cite journal | last1=DeFaria | first1=Doreen | last2=Kroumpouzos | first2=George | title=Rheumatoid Neutrophilic Dermatitis as Presenting Sign of Seronegative Arthritis | journal=Acta Dermato-Venereologica | publisher=Medical Journals Sweden AB | volume=84 | issue=3 | date=May 1, 2004 | issn=0001-5555 | doi=10.1080/00015550310007724 | pages=236–237| pmid=15202847 | doi-access=free }}{{cite journal | last1=Ashchyan | first1=Hovik J. | last2=Nelson | first2=Caroline A. | last3=Stephen | first3=Sasha | last4=James | first4=William D. | last5=Micheletti | first5=Robert G. | last6=Rosenbach | first6=Misha | title=Neutrophilic dermatoses | journal=Journal of the American Academy of Dermatology | publisher=Elsevier BV | volume=79 | issue=6 | year=2018 | issn=0190-9622 | doi=10.1016/j.jaad.2017.11.063 | pages=1009–1022| pmid=29653213 | s2cid=4896415 }}{{cite journal | last1=Caucanas | first1=Marie | last2=Heylen | first2=Alain | last3=Rolland | first3=Florence | last4=Müller | first4=Gebhard | last5=Olemans | first5=Catherine | last6=Sass | first6=Ursulla | last7=Vanhooteghem | first7=Olivier | title=Associated pyoderma gangrenosum, erythema elevatum diutinum, and Sweet's syndrome: the concept of neutrophilic disease | journal=International Journal of Dermatology | publisher=Wiley | volume=52 | issue=10 | date=September 23, 2013 | issn=0011-9059 | doi=10.1111/j.1365-4632.2011.05415.x | pages=1185–1188| pmid=24073904 | s2cid=8539323 }}

Histopathological findings include normal epidermis, that may show hyperkeratosis, parakeratosis,{{cite journal | last=Bouffard | first=D. | title=Long-standing verrucous lesion. Chromomycosis | journal=Archives of Dermatology | publisher=American Medical Association (AMA) | volume=131 | issue=10 | date=October 1, 1995 | issn=0003-987X | doi=10.1001/archderm.131.10.1195b | pages=1195b–1196| pmid=7574838 }} focal ulceration with scaly crust,{{cite journal | last1=Sánchez | first1=Jorge L. | last2=Cruz | first2=Alma | title=Rheumatoid neutrophilic dermatitis | journal=Journal of the American Academy of Dermatology | publisher=Elsevier BV | volume=22 | issue=5 | year=1990 | issn=0190-9622 | doi=10.1016/0190-9622(90)70127-4 | pages=922–925| pmid=2335586 }} or spongiosis with intraepidermal blistering,{{cite journal | last1=Lowe | first1=Lori | last2=Kornfeld | first2=Bruce | last3=Clayman | first3=Joseph | last4=Golitz | first4=Loren E. | title=Rheumatoid neutrophilic dermatitis | journal=Journal of Cutaneous Pathology | publisher=Wiley | volume=19 | issue=1 | year=1992 | issn=0303-6987 | doi=10.1111/j.1600-0560.1992.tb01558.x | pages=48–53| pmid=1556266 | s2cid=31454442 }}

Treatments include topical steroids,{{cite journal |last1=Hirota |first1=T K |last2=Keough |first2=G C |last3=David-Bajar |first3=K |last4=McCollough |first4=M L |title=Rheumatoid neutrophilic dermatitis |journal=Cutis |date=October 1997 |volume=60 |issue=4 |pages=203–205 |pmid=9347237}} cyclophosphamide,{{cite journal | last=Mashek | first=Helen A. | title=Rheumatoid Neutrophilic Dermatitis | journal=Archives of Dermatology | volume=133 | issue=6 | date=1997-06-01 | pages=757–760 | issn=0003-987X | doi=10.1001/archderm.1997.03890420097013 | pmid=9197831 }} dapsone, and hydroxychloroquine.

Lesion resolution can happen on its own or as the rheumatoid arthritis progresses, but lesions usually recur when the condition gets worse. Although most lesions heal without leaving scars, hyperpigmentation may linger for a while.{{cite journal | last1=Lazarov | first1=A | last2=Mor | first2=A | last3=Cordoba | first3=M | last4=Mekori | first4=Ya | title=Rheumatoid neutrophilic dermatitis: an initial dermatological manifestation of seronegative rheumatoid arthritis | journal=Journal of the European Academy of Dermatology and Venereology | volume=16 | issue=1 | date=2002 | issn=0926-9959 | doi=10.1046/j.1468-3083.2002.00401.x | pages=74–76| pmid=11952297 | s2cid=30236685 }}

• Sweet's syndrome-like dermatosis
• List of cutaneous conditions

{{reflist}}

• {{cite journal | last1=Żuk | first1=Gabriela | last2=Jaworecka | first2=Kamila | last3=Samotij | first3=Dominik | last4=Ostańska | first4=Elżbieta | last5=Reich | first5=Adam | title=Rheumatoid neutrophilic dermatitis | journal=Rheumatology | publisher=Termedia Sp. z.o.o. | volume=57 | issue=6 | date=December 31, 2019 | issn=0034-6233 | doi=10.5114/reum.2019.90363 | pages=350–353 | pmid=32226170 | pmc=7091481 | ref=none}}
• {{cite journal | title=Rheumatoid neutrophilic dermatosis: A case report and literature review of current treatment options | journal=Journal of the American Academy of Dermatology | publisher=Elsevier BV | volume=60 | issue=3 | year=2009 | issn=0190-9622 | doi=10.1016/j.jaad.2008.11.243 | page=AB52 | ref=none}}

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{{Neutrophilic and eosinophilic dermatosis}}

Category:Reactive neutrophilic cutaneous conditions